What factors drive heterogeneity of preferences for micro-health insurance in rural Malawi?

Abiiro, Gilbert Abotisem; Torbica, Aleksandra; Kwalamasa, Kassim; Allegri, Manuela De

doi:10.1093/heapol/czw049

Cited by 12 publications

(9 citation statements)

References 53 publications

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“…One study in Addis Ababa showed health insurance did not provided suitable financial protection for the insured people [ 37 ]. Another study found the low co-payment when receiving service was one of the priorities of the insured [ 40 ]. In other studies, non-payment or payment of 50% of the costs when receiving the service was among the preferences of the participants.…”

Section: Discussionmentioning

confidence: 99%

“…In other studies, non-payment or payment of 50% of the costs when receiving the service was among the preferences of the participants. Some studies revealed that the increasing level of cost coverage to 90% doubled the probability of choosing health insurance [ 40 – 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our findings also showed that the insurance benefits package was one of the main factors affecting the choice of insurance, similar to the experience of the study in Malawi that reveled the preference of comprehensive and medium benefits packages to the basic packages. In the age group over 55 and also among high-cost households, these preferences were among the main themes [ 36 , 40 ]. In other studies, a comprehensive benefits package was preferred and the full dental benefits were among the expected features to select an insurance [ 37 , 38 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

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“To enroll or not to enroll”: a qualitative study on preferences for dental insurance in Iran

Vahidi

Takian

Amini-Rarani

et al. 2022

BMC Health Serv Res

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Background Oral public health services are included in primary healthcare. Although oral diseases are preventable, improving oral health has become a concern in many countries. Evidence shows that functioning insurance coverage can significantly increase the use of dental health services, improve quality of services, and reduce financial barriers to utilization. Little evidence exists on households’ preferences for dental insurance in Iran. This study seeks to identify the households’ preferences for dental insurance in Tehran-Iran. Method This is a qualitative study. We interviewed 84 participants who visited selected public and private dental clinics in Tehran-Iran, from October 2018 until January 2019. All interviews were recorded and transcribed verbatim. We used a mixed inductive/deductive approach for thematic analysis of the interviews. Results We identified two main themes and 12 sub-themes: pecuniary attributes (insurance premium, coinsurance, insurance coverage granted, discounting option, reimbursement of expenses), and non-pecuniary attributes (notification status, ethical issues, benefits package, contract providers with health insurance, quality of service centers, administrative process, and dental insurance scheme). Conclusion Our participants considered both pecuniary and non-pecuniary attributes for choosing a dental insurance package. Our findings could help, we envisage, policymakers understand Iranian households’ preferences for a dental insurance scheme that they afford to buy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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“To enroll or not to enroll”: a qualitative study on preferences for dental insurance in Iran

Vahidi

Takian

Amini-Rarani

et al. 2022

BMC Health Serv Res

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“…The next two attributes are reimbursement rate and the annual premium per person. In DCE studies on insurance preferences of residents, attributes on the cost were always included ( 35 , 50 – 53 ). The inclusion of the annual premium per person attribute allows for the estimation of residents' willingness to pay for improvements in other attributes.…”

Section: Methodsmentioning

confidence: 99%

Preferences for public long-term care insurance among middle-aged and elderly residents: A discrete choice experiment in Hubei Province, China

Jia

et al. 2023

Front. Public Health

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ObjectiveIt is critical to incorporate residents' preferences into the design of long-term care insurance (LTCI). However, little is known about middle-aged and elderly residents' preferences for personalized need-related attributes of LTCI in China. Through a discrete choice experiment (DCE), we aimed to focus on the direct beneficiaries of LTCI and then elicit their preferences for LTCI under a hypothetical scenario of dysfunction.MethodsAttributes and levels were defined through a literature review and two rounds of expert consultations (n = 8). A D-optimal fractional factorial design was used to generate the DCE questionnaire. Face-to-face interviews with middle-aged and elderly residents were conducted in two cities in Hubei Province, China, between November and December 2020. A mixed logit model was utilized for estimation.ResultsFive attributes were identified and incorporated into the DCE questionnaire. A total of 390 participants completed DCE questionnaires. Care facilities, care content, reimbursement rate, caregivers, and annual premium per person all had a significant impact on residents' preferences. Residents had significantly higher preferences for the LTCI scheme with home and community-based care centers (β = 1.40, p < 0.01), multi-level services (β = 0.44, p < 0.01), 90% reimbursement rate (β = 0.37, p < 0.01), and sufficiently trained caregivers (β = 0.26, p < 0.01). Individual characteristics, such as gender, employment, and education level were the factors that drove heterogeneity in preferences for LTCI.ConclusionThis study provides new evidence on the preferences of middle-aged and elderly residents for personalized need-related public LTCI features. The design of the LTCI scheme in China needs to take these findings into account to maximize the utility for direct beneficiaries of LTCI and enhance their enrollment.

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“…An NHI contribution of MWK 3000 per individual was assumed, based on international experience of membership premiums of ~ 1% of average per capita incomes. A recent estimate of willingness-to-pay for insurance in Malawi was even lower at just above MWK 3000 for coverage of an extended family [7].…”

Section: Methodsmentioning

confidence: 99%

Assessing the feasibility and appropriateness of introducing a national health insurance scheme in Malawi

Gheorghe

Straehler-Pohl²,

Nkhoma

et al. 2019

glob health res policy

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Background In May 2015 the Malawian Ministry of Health (MOH) contacted the German Development Cooperation to seek technical assistance from the P4H Network for Social Health Protection for an “Assessment of the appropriateness and feasibility of National Health Insurance in Malawi” against two alternative options: continuing with a tax (and donor)-funded National Health Service, and introducing a purchaser-provider split without a revenue collection function. Methods A health financing benchmarking matrix was agreed with MOH, with six domains corresponding to six objectives: revenue mobilisation, technical efficiency, equity, financial risk protection, policy coordination, and health outcomes. The assessment comprised key informant interviews with Malawian stakeholders, a review of the relevant literature and datasets, rapid assessments of the Malawi Revenue Authority (MRA) and the Unified Beneficiary Registry (UBR), and projections of the National Health Insurance Scheme’s (NHIS) revenue collection costs and benefits. Results A key finding was that introducing NHIS in Malawi would increase revenues for health, but these would come predominantly from the formal sector and would be unlikely to cover the health sector funding gap. The performance of existing poverty identification and targeting mechanisms was not commensurate with the requirements of a NHIS. Incentives to enrol in NHI are insufficient to reach scale unless service fees be introduced, which would negatively affect equity and financial risk protection. The assessment identified the Purchaser Scenario as the most favourable reform model. Conclusions As ever more countries look towards implementing National Health Insurance, the proposed assessment framework can provide an orientation for evidence-based policy making in the area of health financing. Electronic supplementary material The online version of this article (10.1186/s41256-019-0103-5) contains supplementary material, which is available to authorized users.

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What factors drive heterogeneity of preferences for micro-health insurance in rural Malawi?

Cited by 12 publications

References 53 publications

“To enroll or not to enroll”: a qualitative study on preferences for dental insurance in Iran

“To enroll or not to enroll”: a qualitative study on preferences for dental insurance in Iran

Preferences for public long-term care insurance among middle-aged and elderly residents: A discrete choice experiment in Hubei Province, China

Assessing the feasibility and appropriateness of introducing a national health insurance scheme in Malawi

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