Factors Influencing Willingness to Pay for Community Based Health Insurance in Makoni District, Zimbabwe

Abstract

Background. Lack of health insurance is a leading cause of financial impoverishment from seeking health services. Over 100 million people worldwide become poor as a result of seeking health services. In Zimbabwe, only 10 percent of the population has health insurance. The aim of this study was to investigate factors influencing willingness to pay for a proposed community based health insurance scheme. Methods. This was a cross-sectional descriptive study with 318 respondents aged 19-64 years residing in Makoni district, Zimbabwe. These individuals were not formally employed. Willingness to pay for a proposed Community Based Health Insurance Scheme, using the Contingent Valuation Method with the bidding game, was assessed against some selected Sociodemographic and Health related factors. Statistical significance was determined using Chi-square analysis with a significance level of p≤0.05 Results. The proportion of individuals willing to pay for community based health insurance was 84% and the mean amount they were willing to pay for their households was USD29.82 yearly. This study also revealed a significant association between education (p=0.004), income (p=0.035), health facility type (p=0.010), obtaining integrated care (p=0.021), having a household member requiring long term care (p=0.002), having received information on health insurance previously (p=0.002) and experiencing financial difficulties in paying for health services (p=0.044) with willingness to pay for community based health insurance. Conclusion. Given the proportion of respondents willing to pay for health insurance, a low cost insurance scheme may help protect a large number of Zimbabwean families from financial catastrophe as a result of seeking health services. Increasing knowledge of health insurance and ensuring integrated care in health facilities will increase uptake of health insurance in the community