DETERMINANTS OF INFORMAL SECTOR PARTICIPATION IN THE NATIONAL HEALTH INSURANCE FUND IN KASSALA STATE (EASTERN SUDAN)

Abstract

The aim of this thesis is to identify the main factors that affect the decision of participation in the voluntary scheme of NHIF-Kassala state in eastern Sudan. This scheme was designed to cover the households in the informal sector in Kassala state and it's characterized by its low coverage and high dropout rate. The study used both quantitative and qualitative methods to investigate the perceptions of the participant about the voluntary scheme of NHIF in Kassala state. A primary data from 784 respondents was collected and analyzed by multinomial logistic regression. Then, an in depth interviews was conducted with 5 characters from Kassala state who represent the National Health Insurance Fund, State Ministry Of Health and community leaders Urban and rural areas. The outcome of the study shows that; awareness about the scheme, satisfaction with provided services, education, number of medical visits, health status of the households and distance of health facilities have a significant impact on the enrollment mechanism. Moreover, the study shows that the scheme suffers from adverse selection problem. The thesis concludes that, to motivate participation and maintain membership, the NHIF offices should focus more on increasing the level of awareness among the target households, increase accessibility to health insurance services, especially in rural area, improve the quality of services and reform the selection criteria of the subsidized scheme