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Many low and middle-income countries are increasingly cognisant of the need to offer financial protection to its citizens through pre-payment schemes in order to curb high out of pocket expenditure and catastrophic spending on healthcare. However, there is limited rigorous contextual evidence to make decisions regarding optimal design of such schemes. This study assesses the willingness-to-pay (WTP) for the recently introduced state contributory health insurance scheme (SHIS) in Nigeria. The study took place in 6 local government areas in Kaduna state, North-west Nigeria. Data were collected from a household survey using a three-stage cluster sampling approach, with each household having the same probability of being selected. Interviews were conducted with 4000 individuals in 1020 households. Contingent valuation was used to elicit the willing to pay (WTP) for the household using the bidding game technique. The relationship between socioeconomic status and WTP was also examined using logistic regression models. About 82% of the household heads were willing to pay insurance premiums for their households, which came to an average of 513 Naira (1.68 USD) per month per person. The average amount individuals were willing to pay was lower in rural areas (611 Naira) compared to urban areas (463 Naira). These results were influenced by household size, level of education, occupation and household income. In addition, only 65% of the households had the ability to pay the average premium. Socioeconomic factors influence individuals' WTP for contributory health insurance schemes. It is important to create awareness about the benefits of the insurance scheme, especially in rural areas, and in both the formal and informal sectors in Nigeria. WTP information can inform the amount of insurance premiums. However, it is important to consider differences between the WTP and the cost of benefits package to be offered, as the premium amount may need to be subsidized with public financing.

This cross-sectional descriptive study explored knowledge and perceptions of maternal health and awareness of health services among women and men of reproductive age in rural communities in Zaria, Kaduna state Nigeria. Among the sample of 647 respondents, 72.6% of men and only 35.9% of women had received formal education. Knowledge of maternal health was very low. In a three point scale (poor, fair, good), only 3.1% of men and 1.2% of women had good knowledge of maternal health. The association between the respondents\" educational level and their maternal health knowledge was statistically significant. Socio-economic barriers were identified as limiting this population\"s optimal utilization of maternal health services. Furthermore, some respondents\" perceived available health care services to be of low quality. In order to improve reproductive health in rural northern Nigeria, it is imperative to improve access to formal education, increase knowledge about maternal health care, and improve the quality of care offered in health care facilities Cette étude transversale et descriptive a exploré la connaissance et les perceptions de la santé maternelle et la conscience des services de santé chez les femmes et les hommes en âge de procréation dans les communautés rurales à Zaria, dans l\"état de Kaduna. Parmi les 647 répondants, 72,6% des hommes et seules 35,9% des femmes ont reçu l\"instruction formelle. La connaissance de la santé maternelle était faible. Dans une échelle à trois points (mauvais, passable, bon) seuls 3,1% des hommes et 1,2% des femmes avaient une bonne connaissance de la santé maternelle. L\"association entre le niveau d\"instruction et leur connaissance de la santé maternelle était statistiquement significative. Les obstacles socio-économiques ont été identifiés comme limitant l\"utilisation optimale des services de santé. En plus, quelques répondants ont aperçu les services de soins médicaux comme étant de base qualité. Pour améliorer la santé de la reproduction dans les régions rurale du nord du Nigéria, il est obligatoire d\"améliorer l\"accès à l\"instruction formelle au nord du Nigéria, d\"augmenter la connaissance en matière de la santé maternelle et d\"améliorer la qualité des services rendus dans les établissements de santé. Plus important encore, il faut explorer les options d\"accouchements plus sûrs qui seront acceptables dans les communautés où traditionnellement les femmes accouchent à domicile

This cross-sectional descriptive study explored knowledge and perceptions of maternal health and awareness of health services among women and men of reproductive age in rural communities in Zaria, Kaduna state Nigeria. Among the sample of 647 respondents, 72.6% of men and only 35.9% of women had received formal education. Knowledge of maternal health was very low. In a three point scale (poor, fair, good), only 3.1% of men and 1.2% of women had good knowledge of maternal health. The association between the respondents' educational level and their maternal health knowledge was statistically significant. Socio-economic barriers were identified as limiting this population's optimal utilization of maternal health services. Furthermore, some respondents' perceived available health care services to be of low quality. In order to improve reproductive health in rural northern Nigeria, it is imperative to improve access to formal education, increase knowledge about maternal health care, and improve the quality of care offered in health care facilities. Connaissance et perceptions de la santé maternelle dans l'état de Kaduna, au nord du Nigéria Cette étude transversale et descriptive a exploré la connaissance et les perceptions de la santé maternelle et la conscience des services de santé chez les femmes et les hommes en âge de procréation dans les communautés rurales ? Zaria, dans l'état de Kaduna. Parmi les 647 répondants, 72,6% des hommes et seules 35,9% des femmes ont reçu l'instruction formelle. La connaissance de la santé maternelle était faible. Dans une échelle ? trois points (mauvais, passable, bon) seuls 3,1% des hommes et 1,2% des femmes avaient une bonne connaissance de la santé maternelle. L'association entre le niveau d'instruction et leur connaissance de la santé maternelle était statistiquement significative. Les obstacles socio-économiques ont été identifiés comme limitant l'utilisation optimale des services de santé. En plus, quelques répondants ont aperçu les services de soins médicaux comme étant de base qualité. Pour améliorer la santé de la reproduction dans les régions rurale du nord du Nigéria, il est obligatoire d'améliorer l'accès ? l'instruction formelle au nord du Nigéria, d'augmenter la connaissance en matière de la santé maternelle et d'améliorer la qualité des services rendus dans les établissements de santé. Plus important encore, il faut explorer les options d'accouchements plus sûrs qui seront acceptables dans les communautés où traditionnellement les femmes accouchent ? domicile.

This cross-sectional descriptive study explored knowledge and perceptions of maternal health and awareness of health services among women and men of reproductive age in rural communities in Zaria, Kaduna state Nigeria. Among the sample of 647 respondents, 72.6% of men and only 35.9% of women had received formal education. Knowledge of maternal health was very low. In a three point scale (poor, fair, good), only 3.1% of men and 1.2% of women had good knowledge of maternal health. The association between the respondents' educational level and their maternal health knowledge was statistically significant. Socio-economic barriers were identified as limiting this population's optimal utilization of maternal health services. Furthermore, some respondents' perceived available health care services to be of low quality. In order to improve reproductive health in rural northern Nigeria, it is imperative to improve access to formal education, increase knowledge about maternal health care, and improve the quality of care offered in health care facilities. [PUBLICATION ABSTRACT]