OBJECTIVES

This study was aimed at determining the knowledge and attitude of households towards health insurance; and assessing the willingness to pay for social health insurance across different socioeconomic groups in Osun State.

METHODS

A cross-sectional study using semi-structured digitized questionnaire was conducted by trained interviewers who administered the tool to the female heads of households and all eligible adults above 18 years in selected households. A total 630 household’ heads participated in the survey.

RESULTS

17% of the respondents had knowledge on health insurance and only 1% of respondents are covered by either National/Social or private health insurance. Among the insured respondents, 62% subscribed to health insurance for assured protection in case of unforeseen illness or injury, and to reduce expenditure in case of occurrence of illness/injury. From the 99% uninsured that were assessed on their willingness to enroll, 94% of them expressed willingness to have health insurance coverage, and among them, 30% would do so because of convenience, 27% because of predictability/reduced uncertainty of costs, 26% due to lower cost than at present, and 13% because of family members with high health care needs. The median formal sector workers are willing to pay for household health insurance coverage is 3% of their salary, while the average informal sector non-poor workers are willing to pay USD29 per year, with more people willing to pay in urban than in rural area. Among those not willing to enroll, 60% can’t afford to pay for health insurance.

CONCLUSIONS

The study makes it imperative for government and stakeholders to discuss and negotiate merits of adjusting the premium rate and benefits package to more closely align with citizens’ willingness to pay for insurance, putting into consideration mostly the informal non-poor sector, as long as it is feasible for the survival of the scheme.