scholarly journals Willingness to Pay for a Contributory Social Health Insurance Scheme: A Survey of Rural Residents in Akwa Ibom State, Nigeria

2021 ◽  
Vol 9 ◽  
Author(s):  
Christie Divine Akwaowo ◽  
Idongesit Umoh ◽  
Olugbemi Motilewa ◽  
Bassey Akpan ◽  
Edidiong Umoh ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Insurance Premium ◽  
Health Insurance Scheme ◽  
Social Health ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Rural Residents ◽  
Household Heads ◽  
Set Up

Background: Health insurance is seen as a pathway to achieving Universal health coverage in low- and middle-income countries. The Nigeria Government has mandated states to set up social health insurance as a mechanism to offer financial protection to her citizens. However, the design of these schemes has been left to individual states. In preparation for the set-up of a contributory social health insurance scheme in Akwa Ibom State, Nigeria. This study assesses the willingness-to-pay for a social health insurance among rural residents in the state.Methods: The study was conducted in three local government areas in Akwa Ibom State, South south Nigeria. It was a cross-sectional study with multi-stage data collection using a demand questionnaire. Interviews were conducted with 286 household heads who were bread winners. Contingent valuation using iterative bidding with double bounded dichotomous technique was used to elicit the WTP for health insurance. Multiple regression using least square method was used to create a model for predicting WTP.Findings: About 82% of the household heads were willing to pay insurance premiums for their households. The median WTP for insurance premium was 11,142 Naira ($29), 95% CI: 9,599–12,684 Naira ($25–$33) per annum. The respondents were predominantly middle-aged (46.8%), Ibibio men (71.7%) with an average household size of five persons and bread winners who had secondary education (43.0%) and were mainly pentecostals (51.5%). The mean age of respondents was 46.4 ± 14.5 yrs. The two significant predictors of WTP for insurance premium amongst these rural residents were income of breadwinner (accounts for 79%) and size of household (2%). The regression coefficients for predicting WTP for insurance premium are intercept of 2,419, a slope of 0.1763 for Bread winner income and a slope of 741.5 household size, all values in Naira and kobo.Conclusion: Majority of rural residents in Akwa Ibom State were willing to pay for social health insurance. The amount they were willing to pay was significantly determined by the income of the breadwinner of the household and the size of the family. These findings are relevant to designing a contributory social health insurance scheme that is affordable and sustainable in order to ensure universal health coverage for the citizens.

scholarly journals Population Characteristics and Their Implications on the Benefit Basket of National Social Health Insurance Scheme in Sierra Leone: A Prospective View

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Abraham Isiaka Jimmy ◽  
Kwabena Anarfi Boateng ◽  
Peter Twum ◽  
Deborah Larbie ◽  
Abdul Bangura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Sierra Leone ◽  
Tertiary Care ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Population Characteristics ◽  
Social Health ◽  
Insurance Scheme ◽  
Care Services ◽  
Household Heads

Background. The government of Sierra Leone introduced social health insurance (SHI) scheme to provide universal health coverage to people. This study was carried out to assess the population characteristics and their implications on the benefit basket of the proposed national health insurance scheme. Methods. A cross-sectional study design was employed in six selected districts in Sierra Leone. Quantitative data were collected for this study through the use of semistructured questionnaires with a sample of 1,185 respondents. Data were analysed using descriptive and inferential statistics. Statistical analysis was run at 5% significant level using Stata 14.0 software. Results. The study found that most (83.54%) of the respondents affirmed that children below 18 years should be excluded from premium payments and as high as 71.65% also stated that pregnant women should be excluded as well. The majority, 63.69%, of the respondents want lactating mothers to be excluded from premium payments. Also, 79.87% of respondents wanted mentally challenged persons not to pay premium, while a significant proportion (84.26%) of respondents further affirmed that the aged (above 70 yrs) should also be excluded from premium payment. Most household heads (89.71%) preferred the accreditation of public health facilities. Regarding the level at which healthcare services should be covered by the scheme, 61.45% preferred the primary care services, 89% mentioned secondary care services, and 98.93% affirmed the provision of tertiary care under the scheme. As for the type of care that should be covered by the scheme, 98.66% and 99.73% affirmed outpatient and inpatient care, respectively. Conclusion. From the findings on population characteristics and their implications on the benefit basket for the proposed nation social health in Sierra Leone, most of the household heads want exemptions from paying premium for a section of the population. This provides a clear insight for policy makers into the formulation of the benefit basket.

scholarly journals Strategic purchasing for universal health coverage: examining the purchaser–provider relationship within a social health insurance scheme in Nigeria

2018 ◽  
Vol 3 (5) ◽  
pp. e000917 ◽  
Author(s):  
Enyi Etiaba ◽  
Obinna Onwujekwe ◽  
Ayako Honda ◽  
Ogochukwu Ibe ◽  
Benjamin Uzochukwu ◽  
...  
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Healthcare Providers ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Strategic Purchasing ◽  
Universal Health

BackgroundIn an attempt to achieve universal health coverage, Nigeria introduced a number of health insurance schemes. One of them, the Formal Sector Social Health Insurance Programme (FSSHIP), was launched in 2005 to provide health cover to federal government and formal private sector employees. It operates with two levels of purchasers, the National Health Insurance Scheme (NHIS) and health maintenance organisations (HMOs). This study critically assesses purchasing arrangements between NHIS, HMOs and healthcare providers and determines how the arrangements function from a strategic purchasing perspective within the FSSHIP.MethodsA qualitative study undertaken in Enugu state, Nigeria, data were gathered through reviews of documents, 17 in-depth interviews (IDIs) with NHIS, HMOs and healthcare providers and two focus group discussions (FGDs) with FSSHIP enrolees. A strategic purchasing lens was used to guide data analysis.ResultsThe purchasing function was not being used strategically to influence provider behaviour and improve efficiency and quality in healthcare service delivery. For the purchaser–provider relationship, these actions are: accreditation of healthcare providers; monitoring of HMOs and healthcare providers and use of appropriate provider payment mechanisms for healthcare services at every level. The government lacks resources and political will to perform their stewardship role while provider dissatisfaction with payments and reimbursements adversely affected service provision to enrolled members. Underlying this inability to purchase, health services strategically is the two-tiered purchasing mechanism wherein NHIS is not adequately exercising its stewardship role to monitor and guide HMOs to fulfil their roles and responsibilities as purchasing administrators.ConclusionsPurchasing under the FSSHIP is more passive than strategic. Governance framework requires strengthening and clarity for optimal implementation so as to ensure that both levels of purchasers undertake strategic purchasing actions. Additional strengthening of NHIS is needed for it to have capacity to play its stewardship role in the FSSHIP.

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 Factors affecting the Utilization of Social Health Insurance by the General Population in Bhaktapur Municipality

2020 ◽  
Vol 3 (1) ◽  
pp. 42-48
Author(s):  
Punam Karanjit ◽  
Prajita Mali ◽  
Rakshya Khadka ◽  
Lisasha Poudel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
General Population ◽  
Financial Burden ◽  
Household Head ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
Insurance Scheme ◽  
Factors Affecting

Introduction:  For the reduction of financial burden and to achieve universal health care, Government of Nepal launched a security program called as Social Health Insurance Program. This study aimed to find the factors associated with the utilization of the social health insurance scheme. Methods: Descriptive cross-sectional study was conducted in the Bhaktapur Municipality ward no 2. 422 households were chosen using systematic random sampling. Questionnaires were used to measure the factors affecting the utilization. The collected data was entered in Epidata and analyzed in SPSS version 16. The data were presented in the frequency and percentage. Bivariate analysis was done to identify factors utilizing social health insurance. Factors having p value less than 0.05 was taken as significantly associated. Multivariate analysis was done to examine the association between the outcome variables. Results: Almost half of the general population (42.4 %) were utilizing social health insurance scheme and reason for not utilizing includes lack of confidence in the scheme and the services of the scheme, followed by high premium cost. Age (p=0.044), occupation (p= 0.049), wealth quintiles (p=<0.001) were found to be significantly associated with utilization of social health insurance. Logistic regression analysis showed that the odds of enrollment among very rich population group were lower than the medium (AOR 0.550, 95% CI 0.305-0.993) and rich population (AOR 0.557, 95% CI 0.316-0.981). Conclusions: Multiple factors were found to be associated with the utilization of the health insurance scheme which includes age of the household head, occupation of the household head, economic status, availability of the drugs and charge paid during their visit in the health care services, behavior showed by the health care provider, confidence in the scheme, satisfaction in the services that have been providing and source of the information.

scholarly journals The Benefits of Mandatory Health Insurance. The Institutional Approach in Albania

2015 ◽  
Vol 3 (1) ◽  
pp. 55
Author(s):  
Fjoralba Memia
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
Insurance Fund ◽  
Insurance Scheme ◽  
Social Risks ◽  
Mandatory Health Insurance ◽  
The Way

Albanian health insurance system is currently facing multifaceted challenges, standing in the way of meeting the Government’s commitment to provide basic health care to the entire population. Law no.10383, dated 24.02.2011” On compulsory Health care Insurance in the Republic of Albania”, is a major step in the process of redefining and expanding social health insurance in Albania. The Law establishes a Social Health Insurance Fund as autonomous legal person in charge of financing packages of services for social health insurance beneficiaries. Mandatory health insurance scheme as part of the social protection system has been set up in order to prevent and overcome social risks standing in the way of health care services financing. This research aims to make an analysis of the benefits in context of mandatory health insurance scheme, especially between the Compulsory Healthcare Insurance Fund and health service providers. The research also intends not only to provide a theoretical analyses of legal acts, but also presented some conclusions and concrete practical suggestions in terms of necessary changes.

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