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Health Policy and Planning; 19(2): 120-126
© Oxford University Press 2004

Differential willingness of household heads to pay community-based health insurance premia for themselves and other household members

Hengjin Dong1, Bocar Kouyate2, John Cairns3 and Rainer Sauerborn1

1 Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg, Germany,
2 Nouna Health Research Centre, Nouna, Burkina Faso and
3 Health Economics Research Unit, University of Aberdeen, Aberdeen, UK

Objective: This study compares household heads’ willingness-to-pay (WTP) for community-based health insurance (CBI) for themselves with their WTP for other household members, in order to provide information for policy makers on setting the premium and choosing the enrolment unit.

Method: A random sample of 698 heads of households was interviewed in the northwest of Burkina Faso and a bidding game approach was used to elicit WTP. Factors associated with differences in WTP were identified, including characteristics of the household head and of the household.

Results: Mean WTP by the heads of households for insurance for themselves (3575 CFA) was twice their mean WTP per capita for the household as a whole (1759 CFA). The old have a lower WTP than the young, females have lower WTP than males, the poor have a lower WTP than the rich, and that those with less schooling have a lower WTP than those with more years of schooling.

Conclusion: The differences in household heads’ WTP for insurance for themselves and their WTP to insure their households as a whole need to be considered when setting the insurance premium. WTP information can assist decision makers with the complex problem of choosing the enrolment unit and setting the premium.


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