Determinants of the uptake of improved Community Health Fund (iCHF) among agro-pastoralists’ communities in Malinyi district, Tanzania
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Date
2022
Authors
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Publisher
Sokoine University of Agriculture
Abstract
Agro-pastoralists is a group of people normally living in isolated or peripheral
environments due to their economic activities of livestock keeping which require enough
space for cattle grazing, though they also practice crops farming. Many studies previously
conducted were on the factors or reasons for the low enrolment of Community Health
Fund (CHF) but not the improved Community Health Fund (iCHF). Also, previous
studies were mostly not concentrated on agro-pastoralists’ group which might differ with
other community groups demographically, economically, culturally, socially and even
psychologically. There was inadequate information about the determinants of the uptake
of iCHF in agro- pastoralists’ communities especially the socio-economic, cultural
factors, and the household’s cognitive personal values. This study was about the
determinants for the uptake of iCHF among agro-pastoralists’ communities in Malinyi
District. The study used a cross-sectional research design. The sample size was 100.
Descriptive and Inferential analyses were done using STATA 14. Quantitative data were
obtained from Questionnaire, Laddering Interview, Key Informants Interview, and Focus
Group Discussions. The study revealed that poor health services (51.5%), lack of
awareness/ sensitization meetings (40.8/79.2% respondents), and traditions and customs
were the major factors for low enrolment and renewal of agro-pastoralists to the iCHF.
When felt sick specifically, 53%, 48%, 62%, and 63% for single, married, separated, and
widow respondents respectively went to traditional healers. Moreover, 49%, 42%, 68%,
and 55% for single, married, separated, and widow respondents respectively preferred
traditional herbs when felt sick then went to the health facilities. The effects of major
iCHF attribute to the low enrolment were health services (90%); and benefits package
(88%). The study revealed that age of respondents and iCHF availability were the factors significant at a 95% level of significance (Confidence Interval level II). Using binary
logistic regression, it was found that the β- coefficient for age variable was negative
(-0.107) and the odds ratio was below 1. The influence was significant at (p ≤ 0.05). Also,
the study findings showed that the coefficient of iCHF availability in the community
variable was positive (4.097) and the odds ratio was above 1. The influence was
significant at (p ≤ 0.05). Furthermore, the study findings showed that long-time illness
and educational level had positive coefficients which were significant at (p≤0.05). The
study concluded that most of the demographic and economic characteristics of agro-
pastoralists had direct effects on enrolment of agro-pastoralists in the iCHF. The findings
also complied with the Theory of Demand for Health Insurance. The study recommended
on improvement of the health services, more sensitization meetings, consideration of
agro-pastoralists whenever the Government and development partners plan and
implementation of different interventions. It further recommended that the Ministry of
Natural Resources and Tourism and Regional Administration and Local Government
Authority under the President’s Office should work in coordination.
Description
Dissertation
Keywords
Tanzania, Community Health Fund, Agro-pastoralists, Malinyi district