scholarly journals Willingness and ability to pay for healthcare insurance: A cross-sectional study of Seven Communities in East and West Africa (SevenCEWA)

2021 ◽  
Vol 1 (11) ◽  
pp. e0000057
Author(s):  
Oladimeji Akeem Bolarinwa ◽  
Soter Ameh ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Okello Samson ◽  
...  
Keyword(s):  
Health Insurance ◽  
Secondary Education ◽  
West Africa ◽  
Willingness To Pay ◽  
Healthcare Expenditure ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Ability To Pay ◽  
East And West

Willingness and ability to pay for insurance that would cover primary healthcare services has not been evaluated consistently in different African communities. We conducted a cross-sectional community health survey and examined willingness and ability to pay in 3676 adults in seven communities in four countries: Nigeria, Tanzania, Uganda and Kenya. We used an open-ended contingency valuation method to estimate willingness to pay and examined ability to pay indirectly by calculating the ratio of healthcare expenditure to total household income. Slightly more than three quarters (78.8%) of participants were willing to pay for a health insurance scheme, and just a little above half (54.7%) were willing to pay for all household members. Across sites, median amount willing to pay was $2 per person per month. A little above half (57.6%) of households in Nigeria were able to pay the premium. The main predictors of likelihood of being unwilling to pay for the health insurance scheme were increasing age [aOR 0.99 (95% CI 0.98, 1.00)], being female [0.68 (0.51, 0.92], single [0.32 (0.21, 0.49)], unemployment [0.54 (0.34, 0.85)], being enrolled in another health insurance scheme [0.45 (0.28, 0.74)] and spending more on healthcare [1.00 (0.99, 1.00)]. But being widow [2.31 (1.30, 4.10)] and those with primary and secondary education [2.23 (1.54, 3.22)] had increased likelihood of being willing to pay for health insurance scheme. Retired respondents [adjusted mean difference $-3.79 (-7.56, -0.02)], those with primary or secondary education [$-3.05 (-5.42, -0.68)] and those with high healthcare expenditure [$0.02 (0.00, 0.04)] predicted amount willing to pay for health insurance scheme. The willingness to pay for health insurance scheme is high among the seven communities studied in East and West Africa with socio-demography, economic and healthcare cost as main predictive factors.

PARTICIPATING IN HEALTH INSURANCE AND FACTORS AFFECTING AMONG PERSONS WHOSE ENROLMENT IS VOLUNTARY IN THUA THIEN HUE PROVINCE

2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Factors Affecting ◽  
The People ◽  
Universal Health Insurance Coverage ◽  
The Social

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue

scholarly journals Willingness to Join and Pay for Social Health Insurance Scheme Among employees in Debere Berhan Town, Ethiopia

2019 ◽  
Author(s):  
Wassie Negash Mekonnen ◽  
Mesfin Wondaferew ◽  
Adugnaw Birhane Mekonen
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Contingent Valuation Method ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Insurance Scheme ◽  
The Government

Abstract Back ground: Social Health Insurance improves access to health services among civil servants by removing catastrophic health expenditure. In Ethiopia, only 7.3% of the population covered by health insurance. Due to this fact the government of Ethiopia initiated Social Health Insurance scheme to be applied in the formal employers and employees with compulsory membership of the scheme. This study therefore aimed to assess willingness to join and pay for social health insurance scheme among government and private employees in Debere Berhan Town, Ethiopia .Methods: Cross-sectional study was conducted .At mean time Stratified sampling technique was used to select 619 employees. A modified dichotomous contingent valuation method (CVM) was applied to elicit employees’ willingness to pay. Bi-variant and multivariable logistic regression analysis was done . Then the result at 95% CI and P value <0.05 was declared as variables have statistically significant association. Results: A total of 619 employees with response rate of 97.8% were participated in the study. About 406 (65%) of the respondents were willing to join to Social Health Insurance scheme. Of which 113 (27.8%) of employees were willing to pay the government proposed 3% premium. The employee’s average willingness to pay for social health insurance scheme was 1.88% of their monthly salary. In this study the odds of respondents who had degree and above (AOR=3.608, 95%CI 1.177-11.061), employees good perception on quality health service (AOR=3.150, 95% CI 1.140-8.699) and employees who perceive benefit packages of social health insurance as enough (AOR=5.229, 95%CI: 2.230-12 .594) were higher than the counter parts. Conclusion: Employees willingness to join of the Social Health Insurance scheme(SHIS) is low and very low number of employees agree to pay the government proposed premium for SHIS. So decision-makers should emphasize to revise the benefit packages and the premiums to be contributed. likewise insurance agency and all responsible bodies should aware the society about the importance of social health insurance for the employees.

scholarly journals Awareness and Willingness to Participate in Community Health Insurance Scheme Among Household Heads in Rivers State Nigeria

2021 ◽  
pp. 35-44
Author(s):  
Benjamin O Osaro ◽  
Ishmael D Jaja ◽  
Tondor C Uzosike
Keyword(s):  
Health Insurance ◽  
Healthcare Services ◽  
Health Insurance Scheme ◽  
Willingness To Participate ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Quality Healthcare ◽  
Household Heads ◽  
Rivers State

Background: Community-Based Health Insurance scheme (CBHI) can guarantee access to quality healthcare services and increase universal health coverage. Enrolments for this scheme in Nigeria is however low. This study sought to assess the awareness and willingness of households in Rivers State to participate in CBHI. Methodology: This is a cross-sectional descriptive study done in Rivers State, Nigeria. A total of 332 heads of households recruited through multistage sampling and gave written informed consent were interviewed using a pretested interviewer-administered questionnaire. Participants gave information on their socio-demography, awareness and willingness to participate in CBHI and reasons for unwilling to participate. Data were analyzed using IBM SPSS Statistics 22 and results were presented in frequency tables. Chi-square test was done at P< 0.05.

scholarly journals Antibiotics prescription pattern and determinants of utilization in the national health insurance scheme at a Tertiary Hospital in Nigeria

2019 ◽  
Vol 19 (3) ◽  
pp. 2356-2364
Author(s):  
Roland Nnaemeka Okoro ◽  
Chijioke Nmeka ◽  
Patrick O Erah
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Tertiary Hospital ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Amoxicillin Clavulanate ◽  
One Year

Background: Subsidizing the cost of medicines through insurance schemes increases consumption of medicines and may contribute to irrational use of antibiotics. Objectives: To describe the systemic antibiotics prescriptions patterns and analyze the determinants of their utilization in the National Health insurance Scheme (NHIS).Methods: Established WHO guideline was followed to conduct this cross-sectional retrospective study at University of Nigeria Teaching Hospital, Nigeria. Data were collected from randomly sampled prescription sheets of one year duration. Logistic regression analysis was performed to determine the predictors of antibiotics prescriptions.Results: The results are based on 802 sampled out-patients NHIS prescriptions. Average number of medicines per encounter was 4.0 ± 1.8, whereas 46.9% of antibiotics were prescribed by generic name. Penicillins (most frequently amoxicillin/clavulanate), and nitroimidazole (most frequently metronidazole) were the most commonly prescribed antibiotics with percentage share of 43.3% and 22.2%. Being <5 years old, and taking more than 4 medicines (OR 2.20, 95% CI 1.37-3.55) were the factors associated with the highest risk of antibiotics exposure.Conclusion: There were poly-pharmacy, and non-adherence to generic antibiotic prescriptions. Penicillins (amoxicillin/clavulanate) were the most commonly prescribed antibiotic class. Being < 5 years old, and taking more than 4 medicines were significant predictors of antibiotics exposure.Keywords: Antibiotics; national health insurance scheme; Nigeria; poly-pharmacy; prescription.

scholarly journals The Relationship of Ability to Pay and Ownership of Health Insurance towards Willingness to Pay Laboratory Services at Persahabatan Hospital, East Jakarta

2020 ◽  
Author(s):  
Siska Putri Utami ◽  
◽  
Yanti Harjono Hadiwiardjo ◽  
Kristina Simanjuntak ◽  
◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Willingness To Pay ◽  
Observational Research ◽  
Chi Square ◽  
Study Program ◽  
Cross Sectional ◽  
Ability To Pay ◽  
Laboratory Services ◽  
The Relationship

ABSTRACT Background: Limited cost of health services, especially in laboratory tests for diagnoses, causes doctors to consider patient’s willingness to pay so the costs are spent more efficiently. Some factors which supposedly affect the willingness to pay are ability to pay and health insurance ownership. This study aims to know the relationship between ability to pay and health insurance ownership with the willingness to pay for laboratory services in outpatients at RSUP Persahabatan. Method: This research was an analytical observational research with cross-sectional design. Samples consisted of 70 outpatients at RSUP Persahabatan laboratory collected by consecutive sampling. The dependent variable is willingness to pay and the independent variable are the ability to pay and insurance ownership measured using a questionnaire. The data was analyzed by Chi-square. Results: Chi-square test results showed relationship between the ability to pay and the willingness to pay for laboratory health services (OR= 13.14; 95% CI= 2.76 to 62.49; p< 0.001). There was no relationship between health insurance ownership and the willingness to pay for laboratory health services (OR= 2.82; 95% CI= 0.85 to 9.33; p= 0.083). Conclusion: High ability to pay will lead to high willingness to pay, since their need for food has been met and they will shift to the need for health. The health insurance ownership does not affect the willingness of patients in paying laboratory service. Keywords: Ability to Pay, Health Insurance, Hospital, Laboratory Services, Willingness to Pay. Correspondence: Siska Putri Utami. Medicine Study Program, Medicine Study Program, Faculty of Medicine, UPN “Veteran” Jakart. Jl. RS. Fatmawati Raya, Pd. Labu, Cilandak district, Depok, West Java, 12450. Email: [email protected]. Phone: (021) 7656971 DOI: https://doi.org/10.26911/the7thicph.04.18

scholarly journals The bypassing of healthcare facilities among National Health Insurance Scheme enrollees in Ibadan, Nigeria

2020 ◽  
Author(s):  
Adetola O Oladimeji ◽  
David A Adewole ◽  
Folashayo Adeniji
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Facilities ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional Survey ◽  
Additional Time ◽  
Cross Sectional

Abstract Background Bypassing occurs when patients knowingly visit a health facility other than the one they live nearest to. In Ibadan, southwest Nigeria, the majority of enrollees in the National Health Insurance Scheme (NHIS) receive medical care in just 12% of the available NHIS-accredited facilities. Given that enrollees access healthcare services at highly subsidized rates under the scheme, this study aimed to determine the factors responsible for the observed distribution of enrollees across these health facilities. Methods The study was a descriptive cross-sectional survey conducted among NHIS enrollees receiving care at outpatient departments of five randomly selected accredited health facilities in Ibadan. A total of 311 NHIS enrollees were consecutively recruited and a semistructured, pretested, interviewer-administered questionnaire was used to elicit information from respondents. Descriptive and inferential statistics were used to present results at 5% level of significance. Distance traveled by patients from their residence to the facilities was measured using Google maps. Results The mean age of respondents was 37.1±16.1 y. There were 167 (53.7%) males and 224 (72.3%) were married. The bypassing rate was 174 (55.3%). More than a third of enrollees, 127 (41.0%), reported that their hospital choice was made based on physician referral, 130 (41.8%) based on personal choice, 26 (8.4%) based upon the recommendation of the Health Management Organization (HMO), while 27 (8.7%) were influenced by friends/family/colleagues. Bypassing was positively associated with educational status (X2 = 13.147, p=0.004). Respondents who bypassed expended additional time and money traveling to the farther away hospitals, 35.1 (±34.66) min and 389.51 (±545.21) naira per visit, respectively. Conclusion The level of bypassing among enrollees was fairly high. Enrollees should be properly guided regarding the need to access healthcare in facilities closer to them by their HMOs and physicians in the case of referrals. This will reduce bypassing and the cost of travel leading to better outcomes among enrollees.

scholarly journals Awareness and Willingness to Pay for Community Based Health Insurance Scheme in North-Western Nigeria

2018 ◽  
Vol 9 (2) ◽  
pp. 19-23
Author(s):  
Giwa Abdulganiyu ◽  
Kabir Muhammad ◽  
Umar Ibrahim ◽  
Suleiman HH ◽  
Lawal BK
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Financial Burden ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Financing System ◽  
Community Based ◽  
Level Of Education ◽  
Community Based Health Insurance ◽  
North Western

There is a need for the communities to develop their health financing system, most especially those that were not covered by the National Health Insurance Scheme (NHIS). This will give the people an opportunity to finance their medical care which in turn would alleviate financial burden at the point of treatment. Therefore, this study is aimed to determine the level of awareness for Community Based Health Insurance Scheme (CBHIS) among communities and to measure the degree of willingness to pay for the scheme in Katsina, North-Western Nigeria. Semi structured interviewer-assisted questionnaires were used to collect information from the respondents. Statistical analyses were performed using SPSS version 20.0. The results indicates that majority of the respondents attained tertiary level of education (68.3%) and 81.1% were employed. About 74.2% were earning more than the Nigerian minimum wage N18, 000 (≈$59). About 52.2% of the respondents were aware of the CBHIS. And 81% were willing to pay for premium while 62.2% will pay between N 1, 000 – 5, 000 (≈$3.3- $16.4). There was strong significant relationship between monthly income and knowledge of CBHIS (p = < 0.0001). However, gender and educational level were not significantly associated with the knowledge of CBHIS. Awareness about CBHIS was not sufficiently adequate but a significant number of the respondents were willing to pay for CBHIS after learning about the scheme. Factors such as level of education and income levels were found to have positive effect on willingness to pay.Bangladesh Journal of Medical Education Vol.9(2) 2018: 19-23

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