Abstract
In rural Cameroon, many people have no access to quality healthcare services. This is largely attributed to lack of private out-of-pocket payment to finance healthcare services. A community-based prepayment health insurance scheme may be implemented to improve healthcare access in rural areas. This study examines the determinants of willingness-to-pay for a community-based prepayment healthcare system using a contingent valuation method conducted in rural Cameroon. To mitigate potential hypothetical bias, a consequential script is introduced in the questionnaire. The results indicate age, religion, profession, knowledge of community-based health insurance, awareness of usual practice in rural areas, involvement in association and disposable income are the key determinants of willingness to pay for a prepayment health scheme. On average, willingness to pay for the scheme by rural households is 1011 CFA francs/person/month (2.15 US dollars). The results underlie two important implications: first, there is substantial demand for a community healthcare prepayment scheme by rural poor households in Cameroon; second, rural households are averse to health shocks and hence they are willing to sacrifice monthly premium payments to protect themselves (and their households) from unforeseen health-related risks. If government could engage in social marketing strategies such as mass media campaigns and awareness, this could prove vital for encouraging participation by the rural poor in healthcare prepayment scheme in Cameroon.
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Aadland D., Caplan A. J. (2003) Willingness to pay for curbside recycling with detection and mitigation of hypothetical bias. American Agricultural Economics Association 85(2): 492–502
Ami, D., Aprahamian, F., Chanel, O., & Luchini, S. (2011, Forthcoming). A test of cheap talk in different hypothetical contexts: The case of air pollution. Environmental and Ressource Economics. doi:10.1007/s10640-011-9464-z (available on the journal website “online first”)
Arrow K., Solow R., Portney P., Leamer E., Radner R., Schuman H. (1993) Report of the NOAA panel on contingent valuation. Federal Register 58(10): 4602–4614
Asenso-Okyere W. K., Osei-Akoto I., Anum A., Appiah E. 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 42(3): 223–237
Asgary A., Willis K., Taghvaei A. A., Rafeian M. (2004) Estimating rural households’ willingness to pay for health insurance. European Journal of Health Economics 5(3): 209–215
Ataguba J., Ichoku E. H., Fonta W. (2008) Estimating the willingness to pay for community healthcare insurance in rural Nigeria. Poverty and Economic Policy, Dakar
Bulte E., Gerking S., List J. A., de Zeeuw A. (2005) The effect of varying the causes of environmental problems on stated WTP values: Evidence from a field study. Journal of Environmental Economics and Management 49(2): 330–342. doi:10.1016/j.jeem.2004.06.001
Cameron T. A. (1988) A new paradigm for valuing non-market goods using referendum data: Maximum likelihood estimation by censored logistic regression. Journal of Environmental Economics and Management 15(3): 355–379. doi:10.1016/0095-0696(88)90008-3
Carson R. T. (2000) Contingent valuation: A user’s guide. Environmental Science and Technology 34(8): 1413–1418
Carson R. T., Flores N. E., Meade N. F. (2001) Contingent valuation: Controversies and evidence. Environmental and Resource Economics 19(2): 173–210. doi:10.1023/A:1011128332243
Carson R. T., Groves R. M., List J. A., Machina M. J. (2004) Probabilistic influence and supplemental benefits: A field test of the two key assumptions underlying stated preferences. University of California, San Diego
Champ P. A., Bishop R. C., Brown T. C., McCollum D. W. (1997) Using donation mechanisms to value nonuse benefits from public goods. Journal of Environmental Economics and Management 33(2): 151–162
Churchill C. (2006) What is insurance for the poor?. In: Churchill C. (eds) Protecting the poor. A microinsurance compendium. International labour office, Geneva, pp 13–23
Davis R. K. (1963) Recreation planning as an economic problem. Natural Resources Journal 3(3): 239–249
Dong H., Kouyate B., Cairns J., Mugisha F., Sauerborn R. (2003a) Willingness-to-pay for community-based insurance in Burkina Faso. Health Economics 12(10): 849–862. doi:10.1002/hec.771
Dong H., Kouyate B., Snow R., Mugisha F., Sauerborn R. (2003b) Gender’s effect on willingness-to-pay for community-based insurance in Burkina Faso. Health Policy 64(2): 153–162
Dong H., Kouyate B., Cairns J., Sauerborn R. (2004a) Differential willingness of household heads to pay community-based health insurance premia for themselves and other household members. Health Policy and Planning 19(2): 120–126
Dong H., Mugisha F., Gbangou A., Kouyate B., Sauerborn R. (2004b) The feasibility of community-based health insurance in Burkina Faso. Health policy 69(1): 45–53
Dorsch, M. (2011). Explaining the willingness to pay for environmental protection. Paper presented at the JMA 2011 conference submission.
Dror D. M., Preker A. S. (2002) Social reinsurance. A new approach to sustainable community health financing. The World Bank, Washington, DC
Dror D. M., Radermacher R., Koren R. (2007) Willingness to pay for health insurance among rural and poor persons: Field evidence from seven micro health insurance units in India. Health policy (Amsterdam, Netherlands) 82(1): 12–27
Greene, W. H. (2003). Econometric Analysis (5th ed.). New Jersey: Pearson Education.
Hanemann W. M. (1984) Welfare evaluations in contingent valuation experiments with discrete response data. American Journal of Agricultural Economics 66(4): 332–341
Hanemann W. M. (1999) Welfare analysis with discrete choice models. In: Herriges J. A., Kling C. L. (eds) Valuing recreation and the environment: Revealed preference methods in theory and practice. Edward Elgar, Cheltenham, pp 33–64
Hanemann M. W., Kanninen B. J. (1999) The statistical analysis of discrete-response CV data. In: Bateman I. J., Willis K. G. (eds) Valuing environmental preferences. Theory and practice of the contingent valuation method in the US, EU, and developing countries. Oxford University Press, Oxford, pp 302–441
Hanemann M., Loomis J. B., Kanninen B. (1991) Statistical efficiency of double-bounded dichotomous choice contingent valuation. American Journal of Agricultural Economics, 73(4): 1255–1263
Hannover, A. K. L. (2010). The monetary value of cultural goods: A contingent valuation study of the municipal supply of cultural goods in Lüneburg, Germany. Working Paper Series in Economics No. 63, Lüneburg, 2007.
Heckman J. J. (1979) Sample selection bias as a specification error. Econometrica 47(1): 153–161
Herriges J., Kling C., Liu C.-C., Tobias J. (2010) What are the consequences of consequentiality?. Journal of Environmental Economics and Management 59(1): 67–81. doi:10.1016/j.jeem.2009.03.004
Jiang Y., Asfaw A., von Braun J. (2004) Performance of existing rural cooperative medical scheme and willingness to pay for the improved scheme. Center for Development Research, Bonn
Khan M. H. (2001) Rural poverty in developing countries: Issues and policies. IMF institute, Washington, DC
Mao Z. (2000) Farmer’s willingness to pay for cooperative medical system. Harvard University Press, Cambridge
Mitchell R. C., Carson R. T. (1989) Using surveys to value public goods: The contingent valuation method. Resource for the Future, Washington
Shaw R. P., Griffin S. C. (1995) Financing health care in Sub-Saharan Africa through user fees and insurance. The World Bank, Washington, DC
Wang H., Yip W., Zhang L., Wang L., Hsiao W. (2005) Community-based health insurance in poor rural China: the distribution of net benefits. Health Policy and Planning 20(6): 366–374. doi:10.1093/heapol/czi045
Whittington D. (1998) Administering contingent valuation surveys in developing countries. World Development 26(1): 21–30. doi:10.1016/S0305-750X(97)00125-3
WHO: (2000) World health report. The World Bank, Washington, DC
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Donfouet, H.P.P., Makaudze, E., Mahieu, PA. et al. The determinants of the willingness-to-pay for community-based prepayment scheme in rural Cameroon. Int J Health Care Finance Econ 11, 209–220 (2011). https://doi.org/10.1007/s10754-011-9097-3
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DOI: https://doi.org/10.1007/s10754-011-9097-3