This facility-based cross-sectional study on business process study report (draft) time-driven activity-based costing of core community-based health insurance activities in community-based health insurance pilot Woredas constructed in three woredas selected for the CBHI pilot intervention between January 1 and 30 2019. This was conducted in six kebeles of the selected woredas. The findings of this survey showed the following.

1. Most facilities share a common process although the unit in charge might be different. The average time spent for membership verification is around 0.47 minutes per beneficiary; however, in most of the facilities members have to wait in a long queue prior to the verification process. CBHI payment request summary sheet takes an average of 3.34 minutes per claim. The average lead time for claim aggregation in the sample facilities is 5.57 minutes per claim.
2. The enrollment activities that are performed at the kebele level vary from woreda to woreda or even among kebeles within the same woreda.
3. The cost of capacity supplied is the total cost of resources used in undertaking the activities under each business process. seventy-five percent of the practical capacity and resources that the use of the scheme was allocated for claims management functions and the remaining 25% of the resources and capacity were allocated for the enrolment process management. A large proportion (Two-third) of the total capacity supplied was to perform claim aggregation and submission activities by health facilities contracted under this scheme. Of the total resources and capacity allocated to undertaking CBHI businesses at CBHI schemes, 25% of the capacity and resources went to conducting enrolment functions.
4. there were a significant proportion of the enrolment and membership renewal activities conducted by managers at the kebele level. In three of the pilot woredas, kebeles spend much time managing enrolment and membership renewal activities. Major activities conducted at the kebele level are; collecting registration forms and payment vouchers from woredas, allocating indigent quota to respective ‘gotes’ and approving it, completing membership application/registration forms, collecting money from members, completing members' data on the provided forms, and CBHI ID card as necessary, sent the completed ID cards to woreda, deposit the collected money and receipts to woreda, collect stamped ID cards from the woreda CBHI scheme and distribute it to members.

• business process
• community-based health insurance
• Woreda
• Tigray region

no

This dataset on business process study report (draft) time-driven activity-based costing of core community-based health insurance activities in community-based health insurance pilot Woredas was constructed in three woredas selected for the CBHI pilot intervention between January 1 and 30, 2019. These woredas were Kilete-Awlalo, Atsbi-Wemberta, and Hawzen, and Kebeles, Gotes, and health facilities were selected by non-probable sampling method. The dataset captures information on establishing baseline time for CBHI business processes at all levels including the Woreda community-based health insurance board, community-based health insurance schemes, contracted public health facilities, Kebele community-based health insurance unit, and Gote level money, collectors. It also includes determining the cost allocated for undertaking the respective activities under each business process and redefining the existing process flow at different levels of the community-based health insurance program. Generally, the objective of this study was to assess the existing community-based health insurance business process in pilot woredas and establish a baseline of time and cost allocated for undertaking the respective processes.

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