Factors Influencing Uptake of Health Insurance Schemes in Karatu District, Tanzania

Abstract

Strengthening health systems require a focus on six essential pillars of any health infrastructure system. This study focused on health financing pillar with an aim of promoting risk pooling. Tanzania subscribes to the global efforts of eradicating poverty. By 2016, only 20% of the Tanzanian total population were enrolled in health insurance systems. Little is known concerning the low registration of Tanzanians to health insurance systems despite the growing number of health insurance schemes over the past years. The objective of this study was to investigate factors influencing uptake of health insurance among the residents of Karatu District in Arusha, Tanzania. A cross sectional descriptive survey research design was used in this study. The study population consisted of 45,065 households from which 381 households were drawn using stratified systematic sampling. Data was collected from the heads of households using a structured questionnaire. Uptake of health insurance in Karatu District was low, with only 109 (32.7%) being enrolled into health insurance. Results show that there was a significant association between status of marriage, gender, age, education level, size of house unit, source of income, monthly income, affordable premiums of Tsh10,000 and uptake of health insurance at a p value<0.05. Results obtained from binary logistics regression analysis indicated that knowledge of benefits (p <0.05, OR=1.5, 95% CI [.417-2.37) had a significant association with uptake of health insurance. The conclusion is that a plethora of elements that motivate the decision of house units to  take up health insurance schemes include; house unit size, education level, status of marriage and age, source of income, monthly income, affordable premiums of Tsh10,000. The study recommends enhanced health insurance awareness initiatives, specifically insurance benefits, registration processes, communication mechanisms, and how to access health services from health facilities who have contract with the health insurance service provider.