The problems of translating economic growth in to improved health and the inability to financernthe health sector without affecting the poor in accessing health services begets a set of socialrnpolicies required to promote health. One alternative to covering poor people in the informalrnsector is community-based health insurance (CBHI) schemes. Community-based healthrninsurance development is a potential strategy to meet the urgent need for hea lth financing in lowincomerncountries. Currently Ethiopian Community Based Hea lth In surance scheme is adopted inrna selected thirteen woredas of four regions (Tigray, Amhara, Oromia and SNNP) as a first pilotrnprogram.rnThe program at South Achefer woreda is severely affected by the inefficiencies of the healthrncenters, administrative complexity, low enrolment ratio and under representation of the poor.rnThis study is aimed to assess the performance of Ethiopian Community Based Health Insurancernat South Achefer Woreda. In doing so both quantitative and qualitative research approaches isrnemployed.rnEnsuring equity in enrollment thro ugh identification of and premium exemptions for individualsrnand grou ps without adequate financial resources to pay referred to as indigents or the "poorest ofrnthe poor", is one of the stated goals of the Ethiopian CBHI. The identi ficat ion and selection ofrnthe poorest of the poor is participatory. The CBHI management board does not have anyrnmechanism to check whether or not these households really are ' ultra poor',rnThe program is financiall y sustainable for 20 I 1/ 12 and 2012113 years at the woreda. But thernscheme was financially viable 2011112 than 2012113 or the scheme at the woreda is fin anciallyrnviable at the decreasing rate.rnEthiopian CBHI members at South Achefer Woreda explained th at, compared to the previousrnperiod when they were not in sured, they visited health facilities more often because all thernfinancial barri ers to the health serv ice is removed.rnPayment problem, gender of the household head, net income, chronic medication, administrativerncomplexity and education of the household head are statistica lly sign ificant facto rs th at affect therninsurance intake decision of household heads at the study area.