Community based health insurance as a viable option for health financing: An assessment of household willingness to pay in Lagos, Nigeria

Abstract

The high cost and effect of out of pocket payments for health care on households in developing countries have led to the use of community-based health insurance (CBHI) as a viable alternative for health care funding. The overall objective of the study was to assess the perception and determinants of willingness-to-pay (WTP) for a proposed community based health insurance scheme in urban and rural households in Lagos State. The multi-stage sampling technique was used with 960 household heads enrolled in the study. A pre-tested, semi-structured, interviewer administered questionnaire was used to collect data from the respondents. The contingent valuation method was used to elicit household willingness to enrol and pay for a proposed community based health insurance scheme. Data was analysed using Statistical Package for Social Sciences software (SPSS) version 17. This study revealed that 86.3% of the households in the rural LGA and 78.6% of the households in the urban LGA were willing to pay for the proposed community based health insurance scheme (p=<0.001). The households were willing to pay a mean amount of ₦957.56 and ₦754.83/household/month in the urban and rural area respectively (p<0.001). The paper concludes by emphasizing the high willingness among households to participate in the proposed hypothetical CHBI scheme. This highlights its prospects of increasing access to quality health care in Lagos especially amongst vulnerable low-income households.