Willingness to Pay For Community Based Health Care Financing Scheme: A Comparative Study among Rural and Urban Households in Osun State, Nigeria

Abstract

Background: Out-of-pocket payment dominates the bulk of health care financing in Osun State as in other parts of Nigeria. Pre-payment plans which have been identified to turn the unexpected health expenditures into predictable form of payments have not received desirable consideration. Given the importance of such pre-payment scheme, the aim of this study is to assess willingness to pay for community based health care financing scheme among rural and urban households in Osun State. Methodology: This is a descriptive, cross-sectional comparative study of willingness to pay for community based health care financing schemes among 450 urban and an equal number of rural households in Osun State using multistage sampling method. Research instruments were pre-coded, pre-tested semi structured interviewer administered questionnaire. Data were analysed using STATA 10 software. Result: The findings from this research showed that rural household heads 373 (82.8%) were more willing to pay for community based health care financing scheme than the urban household heads 232 (51.6%). Premium Urban households were willing to pay ₦1798.90k per year while rural ones were willing to pay ₦ 721.70k. Major factors identified that contribute to willingness to pay in the households are number in the households, level of education, income, distance to the health centers, marital status, age and Male gender. Conclusion: Women, the poor, and people with low level of education were less willing to pay. Therefore, when establishing community based health scheme there should be selective targeting of the vulnerable groups within the communities due to their inability to finance health care payments. The results of this research strongly suggest that contingent valuation surveys are feasible methods for estimating households'willingness to pay for community based health care financing scheme in Osun State. ARTICLE FOCUS  This study is on health care financing in Nigeria as a developing nation  Are household heads willing to pay for community based health care financing scheme?  How much are household heads willing to pay for community based health care financing scheme?  What are the factors contributing to willingness to pay for community based health care financing scheme in Osun state, Nigeria. KEY MESSAGES  Out of pocket payment for health care in Osun state contribute over 70% of health expenditure as well as in Nigeria as a whole.  Community based health care financing as have been established in some resource poor countries and have been proffered to be a viable option as a means of safeguarding the poor from huge burden of medical bills.  This study examines willingness to pay for community based health care financing scheme among rural and urban households in Osun State Nigeria. STRENGTH AND LIMITATION  Majority (82.8%) of the rural households were willing to pay for community based health care financing scheme.  The premium households were willing to pay was small for the sustainability of the scheme  The study did not distinguish public and private health care providers in the willingness to pay questions; this could probably be the major limitation of the study