Perceptions and Experiences of Willingness to Pay for Community Based Health Insurance: A qualitative Stud

Abstract

The study objective was to explore perceptions and experiences of willingness to pay for community-based health insurance and factors that affect their willingness to pay among farming households in Uganda. A qualitative study was done among 33 participants in Uganda. An explorative study design with the phenomenological approach was employed. Both purposive and snowball sampling techniques were used. Isingiro District was selected because it is geographically serviced by community-based health insurance schemes in a region with the largest proportion of members at 57%. Consequently, there is augmented availability of data and generalized results. Key informant interviews and focus group discussions were conducted via semi-structured questionnaires. A univariate and inductive thematic analysis were done. Findings show low level of awareness, perception of low income, high amount of premium, good perception of health status are the barriers to pay and indicate the elderly population are unwilling to pay for the community-based health insurance scheme. Yet, the scheme is designed to ameliorate healthcare encounters of such vulnerable groups. This study provides timely evidence and impetus for strategies that address the increasing burden of healthcare. In conclusion, there has been low level of awareness about community-based health insurance. This study proposes to expand universal health coverage of informal sector workers through increased sensitization and capacity to pay premium. Also, the age factor highlights the need to customize premium for membership based on demographic landscape of the communities. To effectively address the future of community-based health schemes, it is critical to develop effective community evidence-based policy options for a sustainable scheme model. This intervention could engender access to a holistic healthcare service by the informal sector. Thus, it may fast-track the achievement of universal health coverage agenda by 2030.