Media Exposure and the Social Determinants of Health Insurance Coverage in Ethiopia 2011 - 2016

Background: In a push for universal health coverage, Ethiopia introduced two insurance schemes in 2010. Yet coverage rates remain very low. To encourage greater adoption, policymakers require a better understanding of who chooses to enroll and which promotional efforts are most effective in encouraging enrollment. Objective: Using nationally representative Demographic and Health Surveys, this research assessed the social determinants of health insurance coverage, including media exposure, in Ethiopia from 2011-2016. Methods: This research analyzed health insurance coverage and other sociodemographic and media exposure variables using multivariable logistic regression model. Results: Health insurance coverage increased 3.30 times from 1.48% in 2011 to 4.89% in 2016. In both years, coverage was associated with higher education, older age, higher wealth levels, and exposure to newspaper and television. Compared to those with no exposure to newspaper, those with newspaper exposure at least once a week were 1.80 times (2011) and 1.86 times (2016) more likely to be insured. Similar results were obtained for television exposure. Conclusion: Initiatives that target the poor and less educated will be necessary if Ethiopia is to achieve universal health coverage. This research suggests that, to date, newspaper and television mediums have been effective promotion mechanisms for growing enrollment.