An Exploration Of Factors That Influence Health Insurance Participation By Urban High-Density Households In Zimbabwe: Case Of Budiriro 1

The purpose of this study was to investigate factors that influence the decision to participate in health insurance by urban high density households in Zimbabwe using primary data from Budiriro 1 suburb in Harare. This came in the wake of deteriorating health standards and nonparticipation in health insurance schemes on the part of most Zimbabweans. Specifically, the study investigated the major drivers causing majority of healthcare users to rely on out-of-pocket expenditure rather than purchasing medical insurance and examined the influence of socioeconomic and demographic factors such as household income, education level, employment status, religion and gender of household head on the probability of health insurance participation. From the target population, a sample of 120 households were randomly selected and interviewed. A self-administered questionnaire was used to collect data between February and March 2018. Given the discrete nature of health insurance participation, data presentation and analysis was done using both descriptive statistics and the probit model. The study established that the motives for households' reliance on out-of-pocket were lack of awareness, chronic illness and the existence of tariff impasse between medical insurance schemes and healthcare providers. Probit regression results show that the household head's level of education, household income, employment status, and religion positively affect health insurance participation whereas gender was found to negatively influence participation in health insurance. Age and health insurance participation were found to have a quadratic relationship of a concave form. To improve participation in health insurance, the study argues for the health insurance industry to claim greater involvement in the nation's educational achievements and productivity stimulating endeavours. The study also recommends educating all healthcare users, regardless of religion or age on the importance of being insured so as to increase coverage across all age groups as well as on apostolic health care users.