The determinants of the willingness-to-pay for community-based prepayment scheme in rural Cameroon

Abstract

In rural Cameroon, many people have no access to quality healthcare services. This is largely attributed to lack of private out-of-pocket payment to finance healthcare services. A community-based prepayment health insurance scheme may be implemented to improve healthcare access in rural areas. This study examines the determinants of willingness-to-pay for a community-based prepayment healthcare system using a contingent valuation method conducted in rural Cameroon. To mitigate potential hypothetical bias, a consequential script is introduced in the questionnaire. The results indicate age, religion, profession, knowledge of community-based health insurance, awareness of usual practice in rural areas, involvement in association and disposable income are the key determinants of willingness to pay for a prepayment health scheme. On average, willingness to pay for the scheme by rural households is 1011 CFA francs/person/month (2.15 US dollars). The results underlie two important implications: first, there is substantial demand for a community healthcare prepayment scheme by rural poor households in Cameroon; second, rural households are averse to health shocks and hence they are willing to sacrifice monthly premium payments to protect themselves (and their households) from unforeseen health-related risks. If government could engage in social marketing strategies such as mass media campaigns and awareness, this could prove vital for encouraging participation by the rural poor in healthcare prepayment scheme in Cameroon.