Exploring Constraints for willingness-to join to Community- Based Health Insurance Scheme Perceived by Rural Households of Gaibandha District in Bangladesh

Abstract

Due to the lack of necessary public funding and the absence of health insurance the low- income rural people of Bangladesh have no protection against catastrophic health expenditures. May policymakers recommended introducing self- financed healthcare service schemes, such as community-based health insurance scheme (CBHI) for ensuring health security, which could be a new source of financing apart from tax revenue. Hence, the CBHI scheme can populations. To explore the demand of the households for the CBH I scheme in the study area together with exploring the reasons for not joining the scheme. It is believed that this study will help policymakers to assess the WTJ and to identify the constraints for not joining the scheme of the rural households in Bangladesh .Thus, 10 (Ten) reasons had been identified that were the barriers for WTJ to scheme .The Relative Importance Index (RII) method had used describe the relative importance of the specific causes and effects based on the reasons for unwillingness to join the CBHI Scheme by using the Liker scale of five categories. In the study, about 90.1% of respondents expressed their WTJ thought inexperienced with 97.1% for the CBHI scheme. On the other hand, 9.9% were unwilling join the scheme, and the majority of households of them explored their financial inability as the barrier to WTJ the scheme. Besides according to RII method, Government will provide all types of healthcare services free of cost, had considered the most important reason, and Lack of trust in the management of the fund had considered the least important reason for the unwillingness of joining to CBHI scheme .To ensure financial protection , it is very necessary to improve communication, coordination, and partnerships between nongovernment organizations, donors, and government stakeholder involved in CBHI , were recommended.