Journal Article

Factors influencing willingness and ability to pay for social health insurance in Nigeria

Ohiri, Kelechi, Butawa, Nuhu Natie, Akomolafe, Babatunde, Ogundeji, Yewande Kofoworola

2019

Overview

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.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Aged, 80 and over / Analysis / Attitude to Health / Contingent valuation / Decision Making / Earth Sciences / Economic aspects / Educational Status / Female / Global health / Health / Health care costs / Health care policy / Health Expenditures / Health insurance / Health services / Households / Humans / Income / Insurance / Insurance, Health - economics / Local government / Low income groups / Male / Medical care / Medical economics / Medicine and Health Sciences / Metropolitan areas / Middle Aged / Nigeria / People and Places / Public finance / Regression analysis / Regression models / Retirement benefits / Rural areas / Social Class / Social factors / Social Sciences / Social Security - economics / Socio-economic aspects / Socioeconomic data / Socioeconomic Factors / Socioeconomics / Statistical analysis / Subsidies / Subsidies (financial) / Urban areas / Young Adult