Analysis of the Willingness to Pay for Osun Health Insurance Scheme among Farming Households in Rural Areas of Osun State, Nigeria

Almost 70% of total expenses on health are private where out-of-pocket expenditure accounts for 90% in Nigeria, leading to a financial burden on families. This study examined the rural households’ perception and willingness-to-pay (WTP) for Osun Health Insurance Scheme (OHIS) in Osun State. A three-stage sampling technique was employed to select 583 rural farming households from six Local Government Areas. Data on socio-demographic features, issues bordering on health, awareness of health insurance and the willingness to enroll with OHIS. Data obtained were subjected to descriptive statistics, logit and double hurdle model analyses. 61.06% reported two morbidity in the last three months and households’ monthly health expenditure was ₦15,260.72±₦6,644.94. Mean WTP obtained from single-bounded dichotomous format was N4,170.47 while mean WTP from open-ended CV survey was ₦1,216.12 per person per month. WTP decreased significantly with household heads’ sex (p<0.01), awareness of NHIS (p<0.05), affordability of OHIS (P<0.10) and household members suffers arthritis (P<0.01) and increased significantly with age, years of schooling, marital status, household member suffers ailment, health insurance workable, prefer OHIS, monthly health expenditure (p < 0.01), household size (p<0.05) and frequency of hospital visit (p<0.10). Amount willing to pay decreased significantly with household heads’ sex (p<0.01), awareness of NHIS (p<0.05), affordability of OHIS (P<0.10) and household members suffers arthritis (P<0.01) and it increased significantly with age, years of schooling, marital status, preferOHIS, annual farm income (p<0.01), monthly health expenditure, household size, household member suffers ailment, health insurance workable, frequency of hospital visit (p<0.05) and household member suffers ulcer (p<0.10). This study concluded that enrollment from non-formal sectors including farming households was too poor and therefore recommend more enrollment centres and more properly equipped primary health centres (PHCs) needs to be accredited as OHIS participating healthcare service providers in the rural areas of the State.