Factors Affecting the implementation of Improved Community Health Fund (iCHF); Case of Ubungo Municipality area, Dar-es-salaam Region, Tanzania

Abstract

Introduction; In developing countries, lower-income households use their income to pay for healthcare services, which has contributed to many families remaining poor. Therefore, community-based health insurance schemes were targeted to help these households to help them to afford healthcare services even if they didn’t have income at that time. Purpose; The purpose of this study was to analyze health facility, community, and related governmental factors that led to the proper functioning of the improved Community Health Fund scheme in Ubungo Municipality in Tanzania. Methodology; A cross-sectional descriptive study was conducted using online questionnaires distributed among healthcare providers and community members using public-owned health facilities in the Ubungo Municipal Council area between October and November 2021. A Chi-square test was used to analyze the data. Results; Results have shown there was statistically significant (x2=15.697, df=2, n=174, p=0.000) between the health facility level with adequate availability of healthcare providers. Likewise, it was statistically significant (x2=17.527, df=2, n=174, p=0.000) between education level and medical supplies/equipment availability in a health facility. And on the community, it was statistically significant (x2=14.559, df=2, n=199, p=0.001) between income level with satisfaction with the iCHF scheme at a health facility. On community-related factors, it was shown that income level was statistically significant (x2=12.075, df=2, n=199, p=0.000) between with involvement of local leaders in iCHF implementation. Also, it was statistically significant (x2=16.922, df=2, n=199, p=0.000) between income level with community behavior/culture towards iCHF. The occupation was statistically substantial (x2=48.726, df=2, n=199, p=0.000) with the involvement of local leaders in iCHF implementation iCHF. Governmental related factors It was statistically significant between income (x2=21.818, df=2, n=199, p=0.000) and iCHF membership size and (x2=18.676, df=2, n=199, p=0.000) and iCHF premium. Also, on occupation (x2=19.086, df=2, n=199, p=0.001 was statistically significant with iCHF premium and statistically significant (x2=21.289, df=2, n=199, p=0.000) with iCHF membership size. Conclusion; If the quality of health service under the iCHF scheme increases, people are willing to pay for the premium the government will allocate and reduce challenges like the preference of user fee scheme over iCHF, problems faced by the enrollment officers, and inadequate iCHF premium membership size.