Abstract
The government of Sierra Leone introduced Social Health Insurance Scheme as a measure to remove financial barriers that beset the people in accessing health to ensure universal coverage. Under this policy, the citizens were encouraged to subscribe to the scheme to avoid out of pocket payment for healthcare at the point of use. This study was conducted to find out the predictors of willingness among the people to pay for health insurance premium. A cross-sectional study design was employed in six selected districts in Sierra Leone. Quantitative data was collected for this study through the use of semi-structured questionnaire with a sample size of 1185 respondents. Data was analysed into descriptive and inferential statistics using the contingent valuation model. Statistical analysis was run at 5% significant level using Stata version 14.0 software. The results showed that majority of the respondent are willing to join and pay a monthly premium of Le 10 000 (US$1.03) with an estimated mean contribution of about Le 14 089 (US$1.44) and the top five predictors of willingness to pay (WTP) were household monthly income, age, district of resident, gender, and educational qualification. The findings on predictors of WTP premium of Sierra Leone National Social Health Insurance (SLeNSHI), suggests that the socio-demographic characteristics of the population are important in premium design and payment. Efforts at improving the socio-economic statuses of the population could be helpful in premium design and payment.
Highlights
The role governments in developing countries play in funding improvements in the health of their citizens has taken centre stage of discussion as the international community deliberate on the Sustainable Development Goals and health priorities more generally in the post-Millennium Development Goals era.[1,2] The growth in gross domestic product of most of these developing countries in recent time couple with their abilities to roll out more comprehensive health insurance schemes with sufficient tax revenue to fund them, keeps on pointing out that paying attention to these sources may contribute to a more sustainable and accountable funding environment for health in developing countries.[3]
A cross-sectional analytical study was used to find out the predictors of willingness to pay (WTP) for health insurance premium among 1185 household heads from a total household population of 3 587 724 in six districts; Kono (505 491), Bo (574 026), Koinadugu (408 687), Bombali (605 741), Western area Urban (1 050 711), and Western Area Rural (443 068) in Sierra Leone
Majority (29.28%) of household heads were from Western Area Urban district
Summary
The role governments in developing countries play in funding improvements in the health of their citizens has taken centre stage of discussion as the international community deliberate on the Sustainable Development Goals and health priorities more generally in the post-Millennium Development Goals era.[1,2] The growth in gross domestic product of most of these developing countries in recent time couple with their abilities to roll out more comprehensive health insurance schemes with sufficient tax revenue to fund them, keeps on pointing out that paying attention to these sources may contribute to a more sustainable and accountable funding environment for health in developing countries.[3]. Social health insurance is capable of pooling the financial risk of its members on one side, and the premium contributions of households, government, and enterprises on the other. Whenever general healthcare coverage is to be funded through insurance, the financial risk pool needs to portray certain characteristics; (i) involuntary contributions to the risk pool so as to thwart the rich and healthy from opting out; (ii) the risk pool should have great numbers of people, as pools with a fewer number cannot broaden the risk satisfactorily and are too small to handle large health costs; and (iii) where the majority of the members are poor, pooled funds will generally be subsidised from government revenue.[6]
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