Contrasting User Benefit Baskets and Provider Payment Options Seeking National Social Health Insurance Choices in Selected Districts for Sierra Leone

In this article, we examine the healthcare potential of the relationship between User/ Benefit Baskets (BB) and Provider/ Payment Options (PO) evolving in six (6) Regional Districts in Sierra Leone, an emerging country in West Africa, and detail how components of Benefit Baskets and Payment Options can impact the nature and scope of implementing a National Social Health Insurance Program in Sierra Leone. Identified and perceived relationships, as revealed by a cross-sectional study, are presented with contextual data from users and providers in the respective six districts. Quantitative data was collected (from August to December 2019) for this research study using a semi-structured questionnaire with a sample size of 1,503 respondents made up of 1,185 household heads and 318 healthcare providers. Data collection, which began during 2019, was analyzed into essential descriptive and inferential statistics. Statistical analysis was run at a significant 5% level using Stata vs 14.0 software. Our results reveal that factors such as marital status, religion, occupation, monthly income, and the district of residents in Sierra Leone were more likely to influence the magnitude of contributions for the content of a User/ Benefit Basket. In contrast, the selection of a Provider/ Payment Option by healthcare providers – such as Diagnostic-Related Grouping (DRG) and Fees-for-Service (FFS), were more likely to be influenced by the level of care provided by the healthcare providers and by the Regional District in which the service providers were situated and operated. Based on our findings, key contextual factors are most likely to influence the content of BBs and POs in Sierra Leone. Hence, we submit that it is appropriate for such contextual factors associated with BBs and POs to be adequately and rigorously considered upon the implementation of a National Social Health Insurance Program for the people of Sierra Leone.