Willingness to Pay for Social Health Insurance by the Self-employed in Port Harcourt, Rivers State; A Contingent Valuation Approach

Abstract

Background/Aim: Urban Self-Employed Social Health Insurance (USSHIP), which is similar to Community-based health insurance schemes CBHI, USSHIP, is a package in the National Health Insurance Scheme NHIS specific but is not limited to self-employed individuals in Nigeria which has been rarely explored as instrument in financing healthcare in Nigeria. This study was aimed to assess the Willingness-to-Pay (WTP) for USSHIP and its determinants amongst the self-employed in Port Harcourt.
 Methodology: This was a cross-sectional descriptive study of 204 self-employed individuals selected from various trade association in Port Harcourt using semi-structured interviewer-administered pre-tested questionnaires. An iterative bidding approach of the contingent valuation method was used to elicit maximum WTP for the schemes. A multivariate logistic regression analysis was done to determine predictors to WTP. Data collected were analysed using the Statistical Package for Social Science (SPSS), version 23 software.
 Results: The results show that 89.7% were willing to enrol into the program; the median WTP for the scheme per person/per month is ₦300 ($0.83). The predictors of WTP were marital status, level of education and mode of payment of healthcare.
 Conclusion: Sequel to the findings of this study, the WTP amount for social health insurance program by the self-employed is too small, the implications for these findings imply that with the amount stated, the program cannot be successfully implemented. Recognizing this low amount stated for WTP for USSHIP, which is insufficient to scale up the scheme, the government support for the program is highly recommended.

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

“…Similar findings had been reported in other LMICs like Sierra Leone and Ethiopia (17,18). Studies carried out in states in Nigeria have also reported high levels of WTP with 87% in Osun, 82% in Kaduna, 89.7% in Port Harcourt (24,25,27,29). However, an older study on WTP for insecticidal treated nets reported a lower percentage of 40% (30).…”

“…Some studies on WTP for health insurance have been carried out in various parts of Nigeria (14,(22)(23)(24)(25)(26). Majority of these studies report a high rate of willingness to willingness to participate and pay for health insurance, ranging from (25,(27)(28)(29). However, there are also studies reporting low willingness to pay among respondents (30,31).…”

“…The factors associated with WTP are many and vary with context. However, factors that were found to consistently exert a positively influence on WTP include male gender (18,28,30), educational status (18,25,27,28,31), income (16,25,29,30), household size (32), socioeconomic status (30), family size and ability to pay (18). Previously paying for any form of health insurance and previous experience of ill health were also positive factors for WTP (30,33).…”

Willingness to Enroll in Social Health Insurance and associated factors among Household Heads in Obio/Akpor Local Government Area of Rivers State

“…As stated by Anderson and Adeniji (2019), the finance pattern of a country's healthcare system is a determining factor in achieving UHC, while the most viable strategy to achieving UHC is through the provision of subsidized and cheap health insurance coverage, which generally includes protection against the risk of incurring personal medical costs (Alesane & Anang, 2018). Hence, governments in many developing countries have resorted to constructing health insurance models to address these difficulties in order to avoid catastrophic health costs and the necessity to strive for UHC (Fox & Reich, 2015;Kusi et al, 2015;Badu et al, 2018).…”

“…Hence, reports show that it only has about 5% enrolment because it is largely limited to government employers and formal sector workers with regular jobs, leaving the unemployed without coverage (Odeyemi & Nixon, 2013;Shafie & Hassali, 2013). This buttresses the need for the adoption of a social health insurance (SHI) scheme to cover the healthcare needs of the informal sector workers, provide them with financial protection, minimize the equity gap and reduce OOP spending, and enhance utilization of the health care system (Anderson & Adeniji, 2019). However, though the utilisation of SH has been associated with increased access and utilisation of healthcare services in most developed nations (Kusi et al, 2015), such schemes have one or more issues in the eyes of the users, as most of these plans, according to Jain et al (2014), do not cover entire healthcare services but only secondary and tertiary care hospitalization charges.…”