A Mixed-methods Analysis on the Role of Promotional Marketing Strategies on Community-Based Health Insurance Uptake at Kitojo Integrated Development Action

Abstract

Purpose: This study examined associations between promotional marketing strategies and a composite measure of perceived community-based health insurance (CBHI) uptake and service experience at Kitojo Integrated Development Action in western Uganda. Methods: A cross-sectional mixed-methods design was used. A total of 224 completed questionnaires were analysed, and 10 interviews contributed qualitative contextual evidence. Quantitative data were summarised descriptively and examined using separate bivariate linear regression models. Interview material was transcribed and analysed using content analysis, with integration achieved through comparison of quantitative patterns and qualitative accounts. Results: Advertising (R = .893, R² = .797, p < .001), personal selling (R = .919, R² = .845, p < .001), and public relations (R = .887, R² = .787, p < .001) each showed strong bivariate associations with the composite outcome score. Interview accounts described radio programmes, printed materials, direct engagement by staff and group leaders, feedback mechanisms, and community outreach as the principal communication practices. Conclusion: Favourable assessments of promotional communication were strongly associated with favourable assessments of CBHI use and service experience. The findings are context-specific and do not establish that promotion caused enrolment or renewal. Communication strategies should therefore be combined with improvements in affordability, trust, benefit design, service quality, accessibility, and scheme governance.