Abstract

Introduction: Community Based Health Insurance is a not-for-profit type of health insurance managed and operated by community based organizations other than government or private for profit companies that provides resource pooling and risk sharing to cover the cost of all or part of healthcare services. It has been used by poor and rural communities to protect them against the financial risk of illness. Many people in the informal sector and rural communities in Nigeria have been excluded from the National Health Insurance Scheme, thus creating the need for expanding health insurance through the establishment of Community Based Health Insurance Schemes that will cater for the rural and urban poor.
The introduction of Community Based Health Insurance in many parts of Nigeria and Africa as a whole has been hampered by low enrolment rates, limited resource mobilization and poor sustainability because of lack of feasibility study prior to the establishment of such schemes.
Objectives: The aim of this study was to assess the feasibility and need for Community Based Health Insurance in selected rural communities of Ukwuani and Ndokwa-West Local Government Areas of Delta State. The study specifically assessed people’s willingness to join and pay premium for CBHI.
Methodology: It was an exploratory cross-sectional study using both quantitative and qualitative methods of data collection. A modified cluster sampling technique was used to select 412 households from both LGAs. An interviewer administered questionnaire was completed for each household. The double bounded dichotomous choice contingent valuation method was used to assess people’s willingness to pay. The quantitative data was analysed using SPSS version 22 while the qualitative data was analysed manually using the thematic framework for data analysis.
Results: The study revealed that a very high proportion of respondents (99.0% and 97.1%) were willing to join and pay premium for Community Based Health Insurance respectively. The mean individual and household WTP amounts were approximately 600 ± 419 naira per month per person and 1,748 ± 1842 naira per month per household respectively.
Conclusion: There is urgent need for Community Based Health Insurance in the study communities and it is also very feasible to establish a sustainable Community Based Health Insurance Scheme in the study communities. Based on the willingness to join and pay expressed by respondents, it is recommended that urgent effort should be made to establish community based health insurance in the study communities. The design of the scheme should consider the household as the unit of enrolment and there should be proper community mobilization and participation in the planning and implementation of the scheme.