Determinants of Willingness to Join Community- Based Health Insurance Scheme in a Rural Community of North-Western Nigeria

Abstract

Nigeria, as in many developing countries, has most of her citizens (70%) living in rural areas with a majority (about 80%) living below poverty line. They finance their Health care through out-of-pocket expenditure, which is known to result in financial catastrophe, with poor households getting poorer. Community–Based Health Insurance Scheme (CBHIS) is a means of ensuring access to orthodox health care for such rural dwellers.

A cross-sectional study conducted in Madobi community, during Community Diagnosis field practical posting of final year medical students of Ahmadu Bello University, Nigeria, in January 2014. An interviewer-administered questionnaire was used to collect data from 251 heads of households in the community. Data was analyzed using SPSS (version 20).

A majority of the respondents (96%) were willing to join the scheme. There was a statistically significant association between having a large family size and willingness to join the scheme (p=0.033). Respondents whose main source of information on the scheme was a health worker were 1.73 times more likely to join the scheme compared to those whose source of information on the scheme was the interviewers (OR= 1.73, 95 % C.I : 1.16 – 1.94).

The result indicated that several sociodemographic factors like household size and source of information on the scheme were determinants of willingness to join the scheme. Health education on CBHIS through community health workers and solidarity funding for the poorer households were recommended to promote participation in the scheme.