Clients’ Knowledge and Satisfaction with Utilizing Healthcare Services in Community-Based Health Insurance Program and Its Associated Factors among Public Health Centers in Addis Ababa, Ethiopia

Abstract Background: Clients’ satisfaction is a critical strategic weapon to community-based health insurance (CBHI) program that can make the already enrolled members to be retained, new members attracted and increases program sustainability. However, there is a lack of literature on clients’ knowledge and satisfaction with utilizing healthcare services through CBHI program in Ethiopia. This study aimed to determine the knowledge and satisfaction of clients with utilizing outpatient healthcare services in a CBHI program and explores the associated factors among public health centers in Addis Ababa, Ethiopia. Methods and materials: Facility-based cross-sectional study design was conducted on 785 clients selected using systematic random sampling technique from Dec 15, 2021, to Jan 20, 2022. Data entry was done using Epi-Data version 3.1 and exported to SPSS version 26.0 for statistical analysis. Descriptive statistics-mean and median, bi-variate and multivariable logistic regression analysis were computed. P-value < 0.05 was used to determine significant predictors. Result: The overall clients’ satisfaction level on utilizing outpatient healthcare services in CBHI program was 60.2%. The level of clients’ knowledge of the benefit package was 66.4%. Factors significantly associated with clients’ satisfaction were family size >5 members[AOR=4.28(95%CI 1.87,9.81)]; knowledge about benefits package[AOR=2.27(95%CI 1.31,3.92)]; friendliness[AOR=0.05(95% CI 0.02,0.09)], privacy and confidentiality[AOR=6.05(95%CI 3.55,10.31)], got prescribed drugs[AOR=8.75(95%CI 4.56,16.78)], availability of laboratory services[AOR=12.83(95%CI 6.78,24.28)]; perceived cleanness[AOR=3.32(95%CI 1.69,6.53)], waiting time[AOR=12.98(95%CI 7.02,24.01)], the way queries dealt by staff[AOR=9.41(95%CI 4.91,18.02)]; and agreement with benefits package of CBHI[AOR=0.03(95%CI 0.01,0.22)]. Conclusion: The overall level of clients’ satisfaction and knowledge in this study were moderate and needs improvement. The results highlighted the importance of awareness about the benefits package, interpersonal care, availability of resources, consensus with the benefits packages, improving complaints handling way, and shortening the overall waiting time in improving clients’ satisfaction with utilizing healthcare through the CBHI program. Therefore, special attention from stakeholders should be in place to address these findings.