Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, Pakistan
Objective: To utilize the integrated behavioural model (IBM) for identifying predictors of utilization of state-funded health insurance in Khyber-Pakhtunkhwa province, Pakistan. Methods: Using a cross-sectional design, the household survey was conducted across ten districts of the KP province durin...
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Pakistan Medical Association
2024-11-01
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| Series: | Journal of the Pakistan Medical Association |
| Online Access: | https://jpma.org.pk/index.php/public_html/article/view/22960 |
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| author | Junaid Ur Rehman Siddiqui Waqas Hameed Mahnoor Fatima Shifa Salman Habib Kiran Sohail Azeemi Ali Hussaini Asma Altaf Hussain Merchant Adil Haider Sameen Siddiqi |
| author_facet | Junaid Ur Rehman Siddiqui Waqas Hameed Mahnoor Fatima Shifa Salman Habib Kiran Sohail Azeemi Ali Hussaini Asma Altaf Hussain Merchant Adil Haider Sameen Siddiqi |
| author_sort | Junaid Ur Rehman Siddiqui |
| collection | DOAJ |
| description |
Objective: To utilize the integrated behavioural model (IBM) for identifying predictors of utilization of state-funded health
insurance in Khyber-Pakhtunkhwa province, Pakistan.
Methods: Using a cross-sectional design, the household survey was conducted across ten districts of the KP province during
Nov 22-Feb 23 which included a total of 1750 households. Exploratory factor analysis (EFA) and confirmatory factor analysis
(CFA) were used to identify and validate the emerging factors, respectively. Structural equation modelling (SEM) was used
to validate the causal relationships in the final model.
Results: Six factors were identified through EFA namely, Perception of Financial Protection, Perceived Benefits around Sehat
Card Plus Programme (SCP-P), Perceived Norm around SCP-P, Personal Agency to use SCP-P, Intention to use SCP-P, and
Knowledge of SCP-P. Factors’ reliability and validity were established using CFA with coefficients > 0.7.The final structural
model yielded a good fit with a Root Mean Squared Error of Approximation (RMSEA) <0.06 and Comparative Fit Index (CFA)
>0.97. Perception of financial protection (B=-0.3) is inversely related to how people viewed the benefits of using SCP. In
other words, the more people feel financially protected, the fewer benefits they see in the SCP-P. People's intention to use
SCP in the future was mostly influenced by two factor: first, whether they felt using SCP was the norm (B= 0.6) or expected
behaviour in the society like by friends and family, and second, whether they believed using SCP would be beneficial (B=
0.5). People's actual use of SCP in the past year was dependant on intention to use the programme (B=0.2), their knowledge
as to how much they know about it (B=0.2), and their personal ability or control over using it (B=0.3).
Conclusion: The analyses guide SCP-P’s communication and engagement strategy, emphasizing that programme efforts
should focus on promoting positive perceptions and norms surrounding SCP, highlighting its benefits, providing education
and information to enhance knowledge about SCP, and empowering individuals with a sense of personal agency to improve
SCP utilization in the province.
Keywords: Integrated Behavioural Model (IBM), Health Insurance Utilization. Behaviour Model Validation, Structural
Equation Modelling (SEM), Perception of Financial Protection.
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| format | Article |
| id | doaj-art-9fa81b4df4b947408890107fad0a40e7 |
| institution | Kabale University |
| issn | 0030-9982 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Pakistan Medical Association |
| record_format | Article |
| series | Journal of the Pakistan Medical Association |
| spelling | doaj-art-9fa81b4df4b947408890107fad0a40e72025-08-20T03:39:56ZengPakistan Medical AssociationJournal of the Pakistan Medical Association0030-99822024-11-017411 (Supple-11)10.47391/JPMA.SCPP-09Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, PakistanJunaid Ur Rehman Siddiqui0Waqas Hameed1Mahnoor Fatima2Shifa Salman Habib3Kiran Sohail Azeemi4Ali Hussaini5Asma Altaf Hussain Merchant6Adil Haider7Sameen Siddiqi8Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;The Clinical and Translational Research Centre, Medical College, Aga Khan University, Karachi, Pakistan;Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;Medical College, Aga Khan University, Karachi, Pakistan. Objective: To utilize the integrated behavioural model (IBM) for identifying predictors of utilization of state-funded health insurance in Khyber-Pakhtunkhwa province, Pakistan. Methods: Using a cross-sectional design, the household survey was conducted across ten districts of the KP province during Nov 22-Feb 23 which included a total of 1750 households. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to identify and validate the emerging factors, respectively. Structural equation modelling (SEM) was used to validate the causal relationships in the final model. Results: Six factors were identified through EFA namely, Perception of Financial Protection, Perceived Benefits around Sehat Card Plus Programme (SCP-P), Perceived Norm around SCP-P, Personal Agency to use SCP-P, Intention to use SCP-P, and Knowledge of SCP-P. Factors’ reliability and validity were established using CFA with coefficients > 0.7.The final structural model yielded a good fit with a Root Mean Squared Error of Approximation (RMSEA) <0.06 and Comparative Fit Index (CFA) >0.97. Perception of financial protection (B=-0.3) is inversely related to how people viewed the benefits of using SCP. In other words, the more people feel financially protected, the fewer benefits they see in the SCP-P. People's intention to use SCP in the future was mostly influenced by two factor: first, whether they felt using SCP was the norm (B= 0.6) or expected behaviour in the society like by friends and family, and second, whether they believed using SCP would be beneficial (B= 0.5). People's actual use of SCP in the past year was dependant on intention to use the programme (B=0.2), their knowledge as to how much they know about it (B=0.2), and their personal ability or control over using it (B=0.3). Conclusion: The analyses guide SCP-P’s communication and engagement strategy, emphasizing that programme efforts should focus on promoting positive perceptions and norms surrounding SCP, highlighting its benefits, providing education and information to enhance knowledge about SCP, and empowering individuals with a sense of personal agency to improve SCP utilization in the province. Keywords: Integrated Behavioural Model (IBM), Health Insurance Utilization. Behaviour Model Validation, Structural Equation Modelling (SEM), Perception of Financial Protection. https://jpma.org.pk/index.php/public_html/article/view/22960 |
| spellingShingle | Junaid Ur Rehman Siddiqui Waqas Hameed Mahnoor Fatima Shifa Salman Habib Kiran Sohail Azeemi Ali Hussaini Asma Altaf Hussain Merchant Adil Haider Sameen Siddiqi Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, Pakistan Journal of the Pakistan Medical Association |
| title | Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, Pakistan |
| title_full | Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, Pakistan |
| title_fullStr | Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, Pakistan |
| title_full_unstemmed | Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, Pakistan |
| title_short | Applying the integrated behavioural model to identify predictors of utilisation of state-funded health insurance in Khyber Pakhtunkhwa province, Pakistan |
| title_sort | applying the integrated behavioural model to identify predictors of utilisation of state funded health insurance in khyber pakhtunkhwa province pakistan |
| url | https://jpma.org.pk/index.php/public_html/article/view/22960 |
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