Willingness to Pay for Community Health Financing: An Approach to Financing and Sustainability of Integrated Community Case Management of Childhood Illness in Rural Communities in Niger State

Abstract

Introduction: Community based health financing mechanism is referred to as a process whereby household in a community finance or co finance the recurrent and capital cost associated with a given set of health services thereby also include management of financial scheme and organization of health services.
 Iccm as a strategy to providing integrated case management services for two or more illness including diarrhea, malaria, pneumonia among children from two to upto five years. It is a community approach where lay persons are trained on management of the three diseases. This approach is being funded by foreign donor. However, there was stipulated period in which this support would elapsed and the support from the state Government may not be feasible. In an attempt to source for financing of iccm, this study aim at determining the willingness of the caregiver to use Community financing approach through payment of Premium to finance this community intervention (iccm). The concept of willingness to pay is maximum price a consumer is willing to pay for a given product or services.
 Materials and Methodology: A descriptive Cross sectional study was carried out among four hundred respondents that were selected using Multi stage sampling technique. Data was collected, coded and entered into a computer. Analysis was carried out using SPSS. Chi Square and logistic regression was used as a test of significance. Level of significance was set at Pvalue less than 0.05.
 Results: Twenty two percent of the respondents had good knowledge of iccm activities. Less than half of the respondents 41.3% were satisfied with iccm activities. Majority of the respondents 93.3% were willing to pay. Out of this, half of them 50.0% said they could only afford to pay less than 1000 naira per annum and 72.8% said the convenient time to pay was during the harvesting time. Factors influencing willingness to pay include Age, marital status and income level ( Pvalue <0.05). Knowledge and level of satisfaction were not influencing factors. The predictor of willingness to pay are aged 38-47 years and income of less than 5000 naira.
 Conclusion and Recommendation: There was willingness of the respondents to contribute for financing and sustainability of iccm in Niger State but the amount the majority of them were willing to pay was less than 1000 naira which might not able to sustain the iccm activities. There may be need for further research to determine amount needed for the annual activities and hence sustainability of iccm. The Government should show much responsibilities toward financing of iccm. Bi-apartite arrangement could be made between State Government and the Communities with iccm in place on how to share some responsibilities of iccm activities.