Willingness to pay and accept social health insurance varies across regions owing to the impact of knowledge, attitude, and perception among employees. Ethiopia has introduced a social health insurance scheme despite facing challenges in its acceptance by the formal sector, and little is known about the knowledge of, attitudes towards, and perceptions of social health insurance. Therefore, this study aimed to assess the knowledge, attitude, and perception regarding social health insurance and its associated factors among health professionals at public health facilities in Gondar City, Northwest Ethiopia. A facility-based cross-sectional and phenomenological design was used in this study. Four hundred and twenty-two participants and two focus group discussions were used for quantitative and qualitative studies, respectively. Self-administered questionnaire and focused group guide were used for data collection. Final participants were selected using purposive and stratified simple random sampling techniques. EPI data and open code software were used for data coding, entry and then exported to SPSS for analysis. Binary logistic regression and thematic analysis were used for quantitative and qualitative analysis respectively. Of the 422 participants, 70.1%, 74.4%, and 53.6% had poor knowledge, unfavourable attitude and good perceptions, respectively, with a 99.1% response rates for both qualitative and quantitative results. Regarding factors, work experience (AOR= 2.4, 95%CI: 1.28, 2.69),age(AOR=1.3,95%CI:1.16,1.72),salary(AOR=1.4,95%CI:1.25,1.99),profession(AOR=2.2,95%CI:1.69,7.43),maritalstatus(AOR=2.3,95%CI:1.23,13.7),beingtrained(AOR=4.7,95%CI:1.23,17.98),historyofsickness(AOR=2.1,95%CI:1.32,5.61),chronicillness(AOR=1.9,95%CI:1.24,3.92), having more dependents (AOR= 1.4,95%CI: 1.04,1.97) were statistically associated with knowledge and attitude. Besides, Sex (AOR=2.7, 95% CI: 1.19, 3.28), education level (AOR=1.3, 95%CI: 1.29, 4.36), accessing adequate information (AOR=2.1, 95% CI: 1.19, 6.28), salary (AOR=1.4,95% CI: 1.25,1.99), age (AOR=1.6,95% CI: 1.06,2.06) and getting awareness (AOR= 2.6, 95% CI:1.13,4.65) were significantly associated with perception towards social health insurance. The results of the study suggested that both knowledge and attitude towards social health insurance were inadequate and unfavourable, despite positive perceptions found through quantitative analysis. Additionally, the qualitative findings suggested that all three factors - knowledge, attitude, and perception - were poor. These findings highlight the need for targeted interventions to improve understanding and acceptance of social health insurance, and to address the negative attitudes towards it. By doing so, we can work towards increasing access to healthcare services and financial protection for individuals and families.

Keywords: social health insurance, Ethiopia, knowledge, attitude, perception