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Willingness-to-pay for community-based insurance in Burkina Faso

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Author Info

  • Hengjin Dong

    (Department of Tropical Hygiene and Public Health, University of Heidelberg, Germany)

  • Bocar Kouyate

    (Nouna Health Research Centre, Nouna, Burkina Faso)

  • John Cairns

    (Health Economics Research Unit, University of Aberdeen, UK)

  • Frederick Mugisha

    (African Population and Health Research Center, Nairobi, Kenya)

  • Rainer Sauerborn

    (Department of Tropical Hygiene and Public Health, University of Heidelberg, Germany)

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    Abstract

    Purpose: To study the willingness-to-pay (WTP) for a proposed community-based health insurance (CBI) scheme in order to provide information about the relationship between the premium that is required to cover the costs of the scheme and expected insurance enrolment levels. In addition, factors that influence WTP were to be identified. Methods: Data were collected from a household survey using a two-stage cluster sampling approach, with each household having the same probability of being selected. Interviews were conducted with 2414 individuals and 705 household heads. The take-it-or-leave-it (TIOLI) and the bidding game were used to elicit WTP. Results: The average individual was willing to pay 2384 (elicited by the TIOLI) or 3191 (elicited by the bidding game) CFA (US$ 3.17 or US$ 4.25) to join CBI for him|herself. The head of household agreed to pay from 6448 (elicited by the TIOLI) or 9769 (elicited by the bidding game) CFA (US$ 8.6 or US$ 13.03) to join the health insurance scheme for his|her household. These results were influenced by household and individual ability-to-pay, household and individual characteristics, such as age, sex and education. The two methods yielded similar patterns of estimated WTP, in that higher WTP was obtained for higher income level, higher previous medical expenditure, higher education, younger people and males. A starting point bias was found in the case of the bidding game. Conclusions: Both TIOLI and bidding game methods can elicit a value of WTP for CBI. The value elicited by the bidding game is higher than by the TIOLI, but the two approaches yielded similar patterns of estimated WTP. WTP information can be used for setting insurance premium. When setting the premiums, it is important to consider differences between the real market and the theoretical one, and between the WTP and the cost of benefits package. The beneficiaries of CBI should be enrolled at the level of households or villages in order to protect vulnerable groups such as women, elders and the poor. Copyright © 2002 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.771
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 12 (2003)
    Issue (Month): 10 ()
    Pages: 849-862

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    Handle: RePEc:wly:hlthec:v:12:y:2003:i:10:p:849-862

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Johannesson, Magnus & Jonsson, Bengt & Borgquist, Lars, 1991. "Willingness to pay for antihypertensive therapy -- results of a Swedish pilot study," Journal of Health Economics, Elsevier, vol. 10(4), pages 461-473.
    2. Alan Diener & Bernie O'Brien & Amiram Gafni, 1998. "Health care contingent valuation studies: a review and classification of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 313-326.
    3. Niklas Zethraeus, 1998. "Willingness to pay for hormone replacement therapy," Health Economics, John Wiley & Sons, Ltd., vol. 7(1), pages 31-38.
    4. Phillips, Kathryn A. & Homan, Rick K. & Luft, Harold S. & Hiatt, Patricia H. & Olson, Kent R. & Kearney, Thomas E. & Heard, Stuart E., 1997. "Willingness to pay for poison control centers," Journal of Health Economics, Elsevier, vol. 16(3), pages 343-357, June.
    5. Sauerborn, R. & Nougtara, A. & Hien, M. & Diesfeld, H. J., 1996. "Seasonal variations of household costs of illness in Burkina Faso," Social Science & Medicine, Elsevier, vol. 43(3), pages 281-290, August.
    6. Johannesson, Magnus, 1992. "Economic evaluation of lipid lowering -- A feasibility test of the contingent valuation approach," Health Policy, Elsevier, vol. 20(3), pages 309-320, April.
    7. Klose, Thomas, 1999. "The contingent valuation method in health care," Health Policy, Elsevier, vol. 47(2), pages 97-123, May.
    8. Jin-Tan Liu & James K. Hammitt & Jung-Der Wang & Jin-Long Liu, 2000. "Mother's willingness to pay for her own and her child's health: a contingent valuation study in Taiwan," Health Economics, John Wiley & Sons, Ltd., vol. 9(4), pages 319-326.
    9. Hoehn, John P. & Randall, Alan, 1987. "A satisfactory benefit cost indicator from contingent valuation," Journal of Environmental Economics and Management, Elsevier, vol. 14(3), pages 226-247, September.
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    Cited by:
    1. Xiao-Hua Ying & Teh-Wei Hu & Jane Ren & Wen Chen & Ke Xu & Jin-Hui Huang, 2007. "Demand for private health insurance in Chinese urban areas," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1041-1050.
    2. Tianviwat, Sukanya & Chongsuvivatwong, Virasakdi & Birch, Stephen, 2008. "Prevention versus cure: Measuring parental preferences for sealants and fillings as treatments for childhood caries in Southern Thailand," Health Policy, Elsevier, vol. 86(1), pages 64-71, April.
    3. Hermann Donfouet & Ephias Makaudze & Pierre-Alexandre Mahieu & Eric Malin, 2011. "The determinants of the willingness-to-pay for community-based prepayment scheme in rural Cameroon," International Journal of Health Care Finance and Economics, Springer, vol. 11(3), pages 209-220, September.
    4. Hermann Donfouet & Pierre-Alexandre Mahieu & Eric Malin, 2013. "Using respondents’ uncertainty scores to mitigate hypothetical bias in community-based health insurance studies," The European Journal of Health Economics, Springer, vol. 14(2), pages 277-285, April.
    5. Hermann Donfouet & P. Jeanty & P.-A. Mahieu, 2014. "Dealing with internal inconsistency in double-bounded dichotomous choice: an application to community-based health insurance," Empirical Economics, Springer, vol. 46(1), pages 317-328, February.
    6. Sukanya Tianviwat & Virasakdi Chongsuvivatwong & Stephen Birch, 2008. "Different dental care setting: does income matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(1), pages 109-118.
    7. De Allegri, Manuela & Sanon, Mamadou & Bridges, John & Sauerborn, Rainer, 2006. "Understanding consumers' preferences and decision to enrol in community-based health insurance in rural West Africa," Health Policy, Elsevier, vol. 76(1), pages 58-71, March.
    8. BONAN Jacopo & LEMAY-BOUCHER Philippe & TENIKUE Michel, 2013. "Household's willingness to pay for health microinsurance and its impact on actual take-up: results from a field experiment in Senegal," CEPS/INSTEAD Working Paper Series 2013-15, CEPS/INSTEAD.
    9. Shafie, A.A. & Hassali, M.A., 2013. "Willingness to pay for voluntary community-based health insurance: Findings from an exploratory study in the state of Penang, Malaysia," Social Science & Medicine, Elsevier, vol. 96(C), pages 272-276.
    10. David Whynes & Emma Frew & Jane Wolstenholme, 2005. "Willingness-to-Pay and Demand Curves: A Comparison of Results Obtained Using Different Elicitation Formats," International Journal of Health Care Finance and Economics, Springer, vol. 5(4), pages 369-386, December.
    11. Pokhrel, Subhash & Snow, Rachel & Dong, Hengjin & Hidayat, Budi & Flessa, Steffen & Sauerborn, Rainer, 2005. "Gender role and child health care utilization in Nepal," Health Policy, Elsevier, vol. 74(1), pages 100-109, September.
    12. Su, Tin Tin & Sanon, Mamadou & Flessa, Steffen, 2007. "Assessment of indirect cost-of-illness in a subsistence farming society by using different valuation methods," Health Policy, Elsevier, vol. 83(2-3), pages 353-362, October.
    13. Shono, Aiko & Kondo, Masahide & Ohmae, Hiroshi & Okubo, Ichiro, 2014. "Willingness to pay for public health services in rural Central Java, Indonesia: Methodological considerations when using the contingent valuation method," Social Science & Medicine, Elsevier, vol. 110(C), pages 31-40.
    14. Hengjin Dong & Adjima Gbangou & Manuela Allegri & Subhash Pokhrel & Rainer Sauerborn, 2008. "The differences in characteristics between health-care users and non-users: implication for introducing community-based health insurance in Burkina Faso," The European Journal of Health Economics, Springer, vol. 9(1), pages 41-50, February.

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