Barriers and facilitators to health insurance enrolment among people working in the informal sector in Morogoro, Tanzania
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View abstract on PubMed
Summary
This summary is machine-generated.Enrolling in Tanzania's improved Community Health Fund (iCHF) is challenging for informal workers due to lack of knowledge and service quality concerns. Positive attitudes and social support can encourage enrollment, but targeted information and better services are crucial.
Area Of Science
- Health economics and policy
- Social determinants of health
- Qualitative health research
Background
- Health insurance is vital for universal health coverage, with Tanzania implementing reforms for its informal sector.
- Despite improved Community Health Fund (iCHF) rollout, enrolment in Tanzania's informal sector remains a significant challenge.
Purpose Of The Study
- To explore factors challenging and facilitating iCHF enrolment among local women food vendors (LWFV) and Bodaboda drivers in Tanzania.
- To understand the perspectives of informal sector workers on health financing reforms.
Main Methods
- A qualitative study employing in-depth interviews (n=50) and focus group discussions (n=16) with LWFV and Bodaboda drivers.
- The study utilized the Theory of Planned Behaviour constructs (attitude, subjective norms, perceived control) as a guiding framework.
- Thematic analysis was performed to identify barriers and facilitators of iCHF enrolment.
Main Results
- Key barriers include lack of knowledge about iCHF, negative social influences from peers and family, and perceived control issues regarding service quality and acceptance at non-government facilities.
- Facilitators identified were the perceived financial benefits of iCHF, encouragement from enrolled individuals, and affordable enrolment fees.
- Convergence in views was observed between LWFV and Bodaboda drivers regarding enrolment factors.
Conclusions
- Positive attitudes, perceived control, and social encouragement can motivate informal sector workers to enrol in iCHF.
- Targeted information dissemination and assurance of quality healthcare services, including NCD coverage and broader facility acceptance, are essential for increasing iCHF enrolment.
- Addressing service quality and accessibility is critical for the success of health financing reforms in Tanzania's informal sector.
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