Donfouet Hermann Pythagore Pierre, Makaudze Ephias, Mahieu Pierre-Alexandre, Malin Eric
Department of Public Economics, University of Yaounde II, P.O. Box 1365, Yaounde, Cameroon.
Int J Health Care Finance Econ. 2011 Sep;11(3):209-20. doi: 10.1007/s10754-011-9097-3. Epub 2011 Aug 28.
In rural Cameroon, many people have no access to quality healthcare services. This is largely attributed to lack of private out-of-pocket payment to finance healthcare services. A community-based prepayment health insurance scheme may be implemented to improve healthcare access in rural areas. This study examines the determinants of willingness-to-pay for a community-based prepayment healthcare system using a contingent valuation method conducted in rural Cameroon. To mitigate potential hypothetical bias, a consequential script is introduced in the questionnaire. The results indicate age, religion, profession, knowledge of community-based health insurance, awareness of usual practice in rural areas, involvement in association and disposable income are the key determinants of willingness to pay for a prepayment health scheme. On average, willingness to pay for the scheme by rural households is 1011 CFA francs/person/month (2.15 US dollars). The results underlie two important implications: first, there is substantial demand for a community healthcare prepayment scheme by rural poor households in Cameroon; second, rural households are averse to health shocks and hence they are willing to sacrifice monthly premium payments to protect themselves (and their households) from unforeseen health-related risks. If government could engage in social marketing strategies such as mass media campaigns and awareness, this could prove vital for encouraging participation by the rural poor in healthcare prepayment scheme in Cameroon.
在喀麦隆农村，许多人无法获得优质的医疗服务。这主要归因于缺乏用于支付医疗服务费用的个人自付费用。可以实施基于社区的预付健康保险计划，以改善农村地区的医疗服务可及性。本研究采用在喀麦隆农村进行的条件估值法，考察了基于社区的预付医疗系统支付意愿的决定因素。为了减轻潜在的假设偏差，问卷中引入了一个结果性脚本。结果表明，年龄、宗教、职业、对基于社区的健康保险的了解、对农村地区惯常做法的认识、参与社团情况和可支配收入是支付预付健康计划意愿的关键决定因素。农村家庭对该计划的平均支付意愿为每人每月1011非洲法郎（2.15美元）。这些结果有两个重要启示：第一，喀麦隆农村贫困家庭对社区医疗预付计划有很大需求；第二，农村家庭厌恶健康冲击，因此他们愿意牺牲每月的保费支付来保护自己（及其家庭）免受不可预见的健康相关风险。如果政府能够开展大众媒体宣传和提高认识等社会营销策略，这对于鼓励喀麦隆农村贫困人口参与医疗预付计划可能至关重要。
