Abstract:
Despite the efforts of the Government of Tanzania to integrate healthcare accessibility for farmers in
Agricultural Marketing Co-operative Societies (AMCOS) through the introduction of Ushirika Afra
scheme in 2019, co-operative members continue to rely on out-of-pocket payments for health services.
In efforts to improve this, the current study investigates the predictors of farmers' engagement in health
insurance through co-operatives. A purposive face-to-face questionnaire survey was conducted with 300
farmers who are members of AMCOS that actively participate in the Ushirika Afra scheme. Structural
Equation Modeling (SEM) using Amos 26 was utilized to analyse the predictors of members'
engagement in health insurance through cooperatives. The results confirm the proposed model and
support its hypotheses. The study supports the role of attitude towards health insurance, subjective
norms, farmers health aspirations and perceived behavioral control as predictors of members'
engagement in health insurance through AMCOS. The practical relevance of findings is discussed. The
study identified important predictors of members' engagement in health insurance through AMCOS.
The study is valuable for among others: AMCOS, National Health Insurance Fund, Tanzania Cooperative Development Commission, and co-operative policy makers.
