Determinants of Health Insurance in rural population of South India

Background and objective: Health is a fundamental human right in India and several other countries. The policy concern in developing countries such as India where 70% of the population lives in rural area is not only to reach the entire population with adequate healthcare services, but also to secure an acceptable level of health for all the people through the application of primary healthcare programs. Health insurance is one of the most important aspects of health care management system. This paper tries to identify the determinants of health insurance in rural India. Methods: A Cross sectional community based study was done with sample size of 290 households estimated by using 25% national coverage according to Public Health Foundation of India. The study was conducted between July 2014 to August 2014. 290 families were covered from two Primary Health Centres which come under field practice area of our medical college. A pretested semi structured questionnaire was used to collect data. Data was entered in excel sheet and analysed using SPSS version 17 software. Results and interpretation: In this study 72.5% of respondents were in age group 26-45yrs, 69.4% of respondents were female,82.1% were from below poverty line family,72.4% were from nuclear family, 81% of respondents were aware of health insurance but only 53.1% were actually insured and off the respondents who were not insured 40.9% were not aware of health insurance. The male gender, nuclear family, affordability to pay premium, higher educational status and awareness regarding health insurance was significantly associated with being insured. Conclusions: The main determinants of being insured were male gender, nuclear family, affordability to pay premium and higher education status. In order to bridge this gap in rural India of not being insured is to educate them in order to bring about behavior change among the respondents.