Introduction: Financing is a key factor in determining access to health care. The use of ‘Out of Pocket’ method of payment for health care by most household has been promoting catastrophic spending on health. This is a concern, especially in the developing nations of the world, like Nigeria, where most people are poor. This study objective was, therefore, to assess and compare the level of knowledge of household heads about methods of health care financing, as well as, assess their attitude and practice in rural and urban communities in Ogun State, Nigeria.
Materials and methods: There was a comparative cross sectional study conducted from August to October, 2015. A multi-staged sampling method was used to select 260 household heads, each from the rural and urban Local Government Area (LGA). Research assistants, recruited and trained, collected data, with the aid of an adapted pretested questionnaire from the household heads. The data collected were analyzed using epi info 7 and WinPepi statistical software. The results were presented in frequency tables. Chi-square test was used to assess the associations between categorical variables and t-test was used to compare the quantitative variables. The level of significance was set at p<0.05.
Results: Knowledge of all methods of health care financing was poor in both the rural and urban communities. There was a better knowledge grade among those in urban with about 114 (43.5%), compared to 105 (40.5%) in the rural. The difference was not statistically significant between the two groups. Also, it was observed that about 144 (55.2%) respondent had a positive attitude towards health financing methods in the urban communities, than those in the rural communities which is about 114 (43.8%). Generally, the positive attitude in the urban group was higher when compared to those in the rural groups for both health care financing and health insurance. The
difference between the two groups was statistically significant for both health financing methods and health insurance.
Most of the respondents in the rural and urban groups were willing to enroll and pay for health insurance. The amount they were willing to pay was rather low; between N0 and N500 per person per annum. Most of the respondents’ finance health cost from Out of Pocket . Educational status was the only socio-demographic determinant that was statistically significant in both the rural and urban groups. Marital status was the only socio-demographic determinant of attitude to health financing in the rural group.
Conclusion and Recommendations: The study revealed that knowledge was low, while the attitude of most respondents was positive. Most of the respondents pay for care Out of Pocket, and most of them are willing to enroll in an insurance scheme. More awareness needs to be created on other methods of healthcare financing, apart from the Out of Pocket method. Also, more options should be created for the people; like creating a Community Based Health Insurance and making the National Health Insurance Scheme more accessible to the people.