Abstract
BackgroundThe national health insurance scheme of Nigeria recently proposed a national premium for community based insurance scheme. This study determined the capacity of households in the rural and urban areas in Nigeria to pay for the premium and different hypothetical health insurance schemes namely national health insurance scheme, national urban health insurance scheme, national rural health insurance scheme and regional health insurance schemes. It determined the likely impact of different premiums on membership across socio-economic status quintiles, and then determined the threshold premium affordable to rural and urban households.ResultsThe results show that the mean capacity to pay for the households in different regions ranged from US$194 ± 100 to US$986 ± 907. The threshold premiums of the national health insurance scheme, urban national health insurance and rural health insurance schemes were US$66, US$154 and US$53 respectively.ConclusionsOverall, the threshold premium for rural national health insurance scheme and national health insurance schemes were affordable to the lowest socio economic group. Hence, it is recommended that threshold premium for rural national health insurance scheme be adopted as the maximum premium not to be exceeded in the proposed national health insurance scheme.
Highlights
The national health insurance scheme of Nigeria recently proposed a national premium for community based insurance scheme
Overall, the threshold premium for rural national health insurance scheme and national health insurance schemes were affordable to the lowest socio economic group
It is recommended that threshold premium for rural national health insurance scheme be adopted as the maximum premium not to be exceeded in the proposed national health insurance scheme
Summary
The national health insurance scheme of Nigeria recently proposed a national premium for community based insurance scheme. This study determined the capacity of households in the rural and urban areas in Nigeria to pay for the premium and different hypothetical health insurance schemes namely national health insurance scheme, national urban health insurance scheme, national rural health insurance scheme and regional health insurance schemes. Many low income countries are compelled to rely on community based health insurance (CBHI) to extend financial risk protection to citizens [4]. Having voluntary contributions creates the room for the healthier population to opt out of schemes, and for wealthier groups to aggregate within schemes that offer more comprehensive services compared to those populated by poorer people, which compromises the cross-subsidization objective of insurance pools
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