Factors Influencing Willingness to Participate in a Micro Health Insurance Program: A Study in Urban Karachi

Background: In low- and middle-income countries, weak public health infrastructure and limited healthcare funding often lead to inadequate healthcare services. Private providers bridge this gap, resulting in high out-of-pocket expenses. Micro health insurance programs can enhance access to healthcare and offer financial protection to low-income populations. This study aimed to identify factors influencing the willingness to participate in micro health insurance programs and determine the optimal premium amount. Methodology: A cross-sectional analytical study was conducted in Karachi with 245 participants, using a validated questionnaire. Multiple linear regression was applied to predict willingness to purchase healthcare insurance based on factors such as age, income, education, discretionary income, family employment, and existing health insurance coverage. The contingent valuation method was used to estimate willingness to pay and the premium amount. Data were analyzed using SPSS version 20. Results: Willingness to purchase health insurance was significantly influenced by income, household expenses, education, discretionary income, and health service preferences. Among participants, 36.3% expressed willingness to participate in a micro health insurance program, while 63.7% were unwilling. Conclusion: Willingness to participate in micro health insurance is strongly associated with economic and educational factors, discretionary income, and household expenses. These findings highlight the need for targeted interventions to improve participation in micro health insurance programs, particularly among low-income groups.