Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

Abstract

BACKGROUND: Healthcare costs and poverty are significant barriers to achieving universal access to healthcare. Thus, Community-Based Health Insurance Schemes (CBHIS) are regarded as an influential instrument for providing access to healthcare. For this purpose, this study was carried out in order to assess the community’s Willingness to Pay (WTP) for CBHIS and its determinants among the residents of Lahore City.METHODS: A cross-sectional study was adopted during the period of May 2018 to August 2018 to conduct a standardized questionnaire survey among targeted population of Lahore. A total of 250 households from lower, middle and upper-middle-class areas were approached randomly from which 200 participated in the survey, rendering a response rate of 90.9%. Sample size was determined by using single population proportion formula assuming 5% margin of error and 95% Confidence Interval (CI). Moreover, multiple regression analysis, Pearson’s correlation and t-test were employed to determine relationships between different variables affecting WTP.RESULTS: Sixty-four percent of the respondents were willing to pay for CBHIS. Among the remaining thirty-six% of unwilling the community, income level (p< 0.05, CI=0.34 to 1.11) and education level (p< 0.05, CI=0.52-1.37) were significant predictors of WTP. Moreover, strong positive relation (p<0.05) between people’s awareness and WTP for CBHIS was witnessed. The findings further suggested that the larger population of the willing community was not willing to pay more than 5000 Rs annually.CONCLUSION: Henceawareness level of the community regarding the benefits of CBHIS is a major hindrance. The key policy priority is to increase the community’s awareness regarding the benefits of CBHIS and to increase willingness to pay rate among public.

Is Ethiopian community-based health insurance affordable? Willingness to pay analysis among households in South Central, Ethiopia

“…Those individuals who had high monthly income were more likely to pay for the CBHI scheme than those who had low monthly income (less than 500ETB). This finding is similar with studies done in Malaysia [ 53 ], India [ 54 ], Pakistan [ 38 ], Bangladesh [ 37 ], Cameron [ 51 ], and Sierra Leone [ 55 ]. This could be because respondents with high income might have enough resources to pay for the requested CBHI scheme premium to protect their family members from unpredictable illnesses [ 24 , 38 ].…”

“…This finding is similar with studies done in Malaysia [ 53 ], India [ 54 ], Pakistan [ 38 ], Bangladesh [ 37 ], Cameron [ 51 ], and Sierra Leone [ 55 ]. This could be because respondents with high income might have enough resources to pay for the requested CBHI scheme premium to protect their family members from unpredictable illnesses [ 24 , 38 ]. We found that the distance respondents reside from the public facility had a significant effect on WTP for the CBHI scheme.…”

“…This finding is almost comparable with the study done in Nigeria,82% [ 34 ], Kewiot and EfratanaGedem districts, 79% [ 35 ], and Oromia Region,83.9% [ 36 ]. However, it is less than studies done in Bangladesh, 86.7% [ 37 ], Jimma Zone, 90% [ 24 ], and higher than studies in Pakistan, 64% [ 38 ], Nepal, 71.3% [ 39 ], Nigeria,74.52% [ 40 ], Bugna district,77.8% [ 23 ] and Gemmachis district, 74.8% [ 22 ]. This variation might be due to differences in the sample size, study period, socioeconomic status, and level of awareness of the participants towards the CBHI scheme.…”

An Investigation on Factors Affecting Health Care Expenditures: The Case of Pakistan

“…In this connection, many investigators have carried out studies to investigate the factors that influence healthcare expenditure within the particular nations. Cantarero, Prieto, David, and Santiago (Sana et al, 2020) as well as (Lord et al, 2020) all examined this notion further in their own research. However, other researchers have used cross-national data to investigate what factors influence health care costs.…”

“…In short, Pakistan's health care system is a highly unequal, western-oriented curative care paradigm that fails to meet needs of an overwhelming majority of Pakistanis (Zaidi). Pakistan has done well on several health measures, its recital is not up to standard when compared to that of its South Asian neighbors (Sana et al, 2020). Health is regarded as integral part of human capital and investment in health is regarded as basic human right and which will end in improved human life.…”