Abstract
BackgroundThe risks associated with direct health spending are high in Cameroon, where almost all household income is spent on health care. Moreover, there is no real social security in Cameroon because of the lack of a universal social protection system. ObjectivesThis study aimed to assess the willingness of Cameroonian urban dwellers to subscribe and the amount to pay for voluntary (VCHI) or compulsory community-based health insurance (CCHI). MethodsA cross-sectional study based on a three-stage stratified cluster random sampling design using a bidding game style based on the contingent valuation approach was performed to in the two largest urban areas of Cameroon (Douala and Yaoundé) evaluate the willingness to pay for the VCHI and CCHI. ResultsThe results shown that 46% of respondent were willing to join the CCHI and 41% for VCHI. Furthermore, household income, working sector, chronic disease, health priority, and family size were factors mostly associated (p < 0.001) with the willingness to join CCHI or VCHI. Increase in household income has a positive effect on household's desire for both CCHI and VCHI. While for VCHI, increase of children number resulted in an increment of the premium, contrary to the occurrence of chronic ailment which led in the decrease of the bid. ConclusionsFrom the results, it is clear that city dwellers in Cameroon are ready to join and pay for community health insurance. This willingness was related to their financial power which resulted in an average insurance premium of 9.03 USD and 8.17 USD, respectively for CCHI and VCHI. That bid was found to be enough for an implementation of these types of health insurance in Cameroon.
Highlights
The advancement of medical sciences and the rising standard of living have made it unacceptable for some people to suffer or die from lack of access to basic health care [1]
Our findings were similar to that found in Vietnam [22] where the inhabitants were more willingness to join (WTJ) the compulsory community-based health insurance (CCHI) than voluntary communitybased health insurance (VCHI) contrary to Malaysia [15] and Ethiopia [31] where most of citizens agree to subscribe for the VCHI
Our results showed that compulsory and voluntary health insurance could be accepted in urban areas of Cameroon as an alternative means of financing health care
Summary
The advancement of medical sciences and the rising standard of living have made it unacceptable for some people to suffer or die from lack of access to basic health care [1]. Health insurance is typically regarded as a means to allow financial risk protection and allow the low-income family to have access to health care [5]. Household income, working sector, chronic disease, health priority, and family size were factors mostly associated (p < 0.001) with the willingness to join CCHI or VCHI. Conclusions: From the results, it is clear that city dwellers in Cameroon are ready to join and pay for community health insurance. This willingness was related to their financial power which resulted in an average insurance premium of 9.03 USD and 8.17 USD, respectively for CCHI and VCHI.
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