Abstract
INTRODUCTION: The Government of Nepal introduced a health insurance programme in three districts in 2016. However, it seems that there has not been systematic evidence on whether the current contribution amount (CCA) needed for enrolling in health insurance (HI), is acceptable for those who are willing to enroll. This article aims to assess the respondents' willingness to pay (WTP) for HI. 
 
 METHODS: A cross-sectional study was conducted with 810 randomly selected households in Baglung and Kailali districts and the data was collected using a validated schedule. The socio-demographic characteristics were considered as independent and the WTP as dependent variables respectively. Univariate, bivariate and multivariate analysis were performed. 
 
 RESULTS: Of the total respondents, 74 percent expressed that they could pay nearly three times as much as the CCA. Mean differences in WTP for HI were observed in terms of districts (p<0.001), sex of the respondents (p<0.01), household headship (p<0.05), mother tongue (p<0.001), wealth status (p<0.001), presence of chronic diseases in the family(p<0.05), enrollment in HI(p<0.01), exposure to the radio/FM(p<0.05) and TV(p<0.01), and access to health facilities (p<0.01). The lieklyhood of WTP for HI were lower in Kailali than in Baglung (b= –0.178, p<0.001); with females than with males(b= –0.076, p<0.05); and with the age group £37 years than > 37 years(b= –0.090, p<0.05).
 
 CONCLUSION: The WTP for HI was nearly three times as high as the CCA for all health services if available to them. More than one fourth of the respondents did not know about HI. Therefore, appropriate interventions are needed for awareness raising which may support the WTP as well as enrollment in HI.
Highlights
The Government of Nepal introduced a health insurance programme in three districts in 2016
Mean differences in willingness to pay (WTP) for health insurance (HI) were observed in terms of districts (p
The data in this study suggests that WTP for HI is influenced by the respondents' place of residence in terms of geography, sex, household headship, native language, wealth status, presence of chronic diseases in the family, enrollment in health insurance programme (HIP), knowledge regarding HI, exposure to the media: the Radio/FM or TV and an easy access to health facilities
Summary
The Government of Nepal introduced a health insurance programme in three districts in 2016. It seems that there has not been systematic evidence on whether the current contribution amount (CCA) needed for enrolling in health insurance (HI), is acceptable for those who are willing to enroll. An economic survey of Nepal shows that at the end of the fiscal year 2015/16, 21.6 percent of the total population accounting for more than six million live below the poverty line (Ministry of Finance, n.d.) and struggle for subsistence. The government should not depend only on premium collection or the contribution amount from the people (Nosratnejad, Rashidian, & Dror, 2016).
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