Willingness to Pay for Community Health Insurance Among Households in Wakiso District, Uganda.
Introduction Community Health Insurance (CHI) is advocated for in many developing countries as one way of addressing the ill effects of direct payments for healthcare. It is perceived to be relevant in countries that depend a lot on out of pocket payments for healthcare and where a large part of the population is not engaged in formal employment. Uganda is one such country. In Uganda, community health insurance has been piloted mainly by development partners but has not been fully embraced by the Government as a health financing mechanism. The study therefore was aimed at assessing the willingness of household heads to pay premium for Community Health Insurance (CHI) schemes in Wakiso district, Uganda. Methodology This was a cross-sectional study that collected both quantitative and qualitative data from the study subjects on willingness to pay for community health insurance using a semi-structured questionnaire. The study unit was a household with the household head present at the time of the data collection. Simple random sampling was conducted to select the households to visit per village. A total of 398 households with the household heads were included in the study from 4 sub-districts of Entebbe, Busiro South, Kyadondo East and Kyadondo North. Analysis of the quantitative data was conducted using software, SPSS version 16 while qualitative data was manually transcribed and analyzed. Results Two thirds (63.8%) of the household heads indicated willingness to pay for the CHI despite 39.7% not understating anything about CHI schemes. Most of the households reporting the willingness to pay for CHI were in the 4 th and 5 th income quintiles (15.8% and 13.3% respectively). Unaffordability (28%) was the main reason for the households that were unwilling to pay for CHI schemes. Those willing to pay hoped for better quality of health services (35.8%) provided by the CHI scheme. Households were willing to pay a premium of 1,001-10,000/= Uganda shillings. Statistically, willingness to pay for community health insurance was likely to be influenced by the household income quintile and source of income for medical treatment since at 95% confidence interval, P<0.05. Conclusion Majority of the households in Wakiso district are willing to pay for the community health insurance scheme if introduced in their communities. The suggested minimum premium is likely to be afforded even by the 1 st income quintile households. Recommendation Sensitization on community health insurance is needed across the district if all the households are to embrace the initiative. Standardization of the minimum amount of premium to pay is an area that requires exploration as well.