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


  • 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)


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.

Suggested Citation

  • Hengjin Dong & Bocar Kouyate & John Cairns & Frederick Mugisha & Rainer Sauerborn, 2003. "Willingness-to-pay for community-based insurance in Burkina Faso," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 849-862.
  • Handle: RePEc:wly:hlthec:v:12:y:2003:i:10:p:849-862
    DOI: 10.1002/hec.771

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    References listed on IDEAS

    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. Niklas Zethraeus, 1998. "Willingness to pay for hormone replacement therapy," Health Economics, John Wiley & Sons, Ltd., vol. 7(1), pages 31-38.
    3. 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.
    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. 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.
    6. Klose, Thomas, 1999. "The contingent valuation method in health care," Health Policy, Elsevier, vol. 47(2), pages 97-123, May.
    7. 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.
    8. Asenso-Okyere, W. Kwadwo & Osei-Akoto, Isaac & Anum, Adote & Appiah, Ernest N., 1997. "Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation," Health Policy, Elsevier, vol. 42(3), pages 223-237, December.
    9. 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.
    10. 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.
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