Abstract
Introduction: Uganda is in discussions to introduce a national health insurance scheme. However, there is a paucity of information on household preferences and willingness to pay for health insurance attributes that may guide the design of an acceptable health insurance scheme. Our study sought to assess households’ preferences and willingness to pay for health insurance using a discrete choice experiment.
Methods: This study was conducted from 16 th February 2020 to 10 th April 2020 on 240 households in Kawempe division, Kampala city, stratified into slum and non-slum communities in order to get a representative sample of the area. Four household and policy-relevant attributes were used in the experimental design of the study. Each respondent attended to 9 binary choice sets of health insurance plans. Data were analysed using mixed logit models.
Results: Households from the non-slum and slum communities preferred plans that included both private and public providers to plans that included public providers only (non-slum 0.81 β , P<0.05; slum 0.87 β , p<0.05), and plans that covered extended family members to plans that had limitations on number of family members allowed (non-slum β 0.44, P<0.05; slum 0.36 β, p<0.05). Households from the non-slum community in particular preferred plans that covered chronic illnesses and major surgeries to other plans (0.97 β, P<0.05). Our findings suggest that location of the household matters in determining willingness to pay with households from non-slum communities willing to pay more for the preferred attributes.
Conclusion : Potential health insurance schemes should consider including both private and public providers, fewer restrictions on the number of family members enrolled for both communities; and coverage for chronic illnesses and major surgeries for non-slum communities. However, the inclusion of more family members needs to be weighed against possible depletion of resources.
Household Preferences and Willingness to Pay for Health Insurance in Kampala City: A Discrete Choice Experiment