南苏丹朱巴市公务员对国家健康保险基金的支付意愿：一项条件评估。
Willingness to pay for National Health Insurance Fund among public servants in Juba City, South Sudan: a contingent evaluation.
机构信息
Institute of Public Health and Management, International Health Sciences University, Kampala, Uganda.
Directorate of Policy, Planning, Research and Budgeting, Ministry of Health, Juba, Republic of South Sudan.
出版信息
Int J Equity Health. 2017 Aug 30;16(1):158. doi: 10.1186/s12939-017-0650-7.
BACKGROUND
This study assessed willingness to pay for National Health Insurance Fund (NHIF) among public servants in Juba City. NHIF is the proposed health insurance scheme for South Sudan and aims at achieving universal health coverage for the entire nation's population. One compounding issue is that over the years, governments' spending on healthcare has been decreasing from 8.4% of national budget in 2007 to only 2.2% in 2012.
METHODS
A cross-sectional study design using contingent evaluation was employed; data on willingness to pay was collected from 381 randomly selected respondents and 13 purposively selected key informants working for the national, state and Juba County in September 2015. Qualitative data were analysed using conceptual content analysis. T-tests and linear regressions were performed to determine association between WTP for NHIF and independent variables.
RESULTS
Up to 381 public servants were interviewed, of which 68% indicated willingness to pay varying percentages of total monthly individual income for NHIF. Over two-thirds (67.8%) of those willing to pay could pay up to 5% of their total monthly income, 22.9% could pay up to 10% and the rest could pay 25%. Over 80% were willing to pay up to 50 SSP (1 USD = 10 SSP) premiums for medical consultation, laboratory services and drugs. The main factors influencing the respondents' decisions were awareness, alternative sources of income, household size, insurance cover and religion.
CONCLUSIONS
Willingness to pay is mainly influenced by awareness, alternative sources of individual income, household size, insurance cover and religion. Most of the public servants were aware of and willing to pay for NHIF and prefer a premium of up to 5% of total monthly income. There is need to create awareness and reach out to those who do not know about the scheme in addition to a detailed analysis of other stakeholders. Consideration could be made by the Government of South Sudan to start the scheme at the earliest opportunity since the majority of the respondents were willing to contribute towards it.
背景
本研究评估了朱巴市公务员对国家健康保险基金（NHIF）的支付意愿。NHIF 是南苏丹拟议的健康保险计划，旨在为全国人口实现全民健康覆盖。一个复杂的问题是，多年来，政府在医疗保健方面的支出一直在减少，从 2007 年的国家预算的 8.4%降至 2012 年的仅 2.2%。
方法
采用横截面研究设计，使用意向评估法；2015 年 9 月，从全国、州和朱巴县的 381 名随机选定的受访者和 13 名选定的主要信息提供者中收集了有关支付意愿的数据。使用概念内容分析法对定性数据进行分析。进行了 T 检验和线性回归，以确定 NHIF 的支付意愿与自变量之间的关系。
结果
共采访了 381 名公务员，其中 68%表示愿意根据个人总收入的不同比例为 NHIF 支付费用。在愿意支付的人中，超过三分之二（67.8%）的人可以支付其总收入的 5%，22.9%的人可以支付 10%，其余的人可以支付 25%。超过 80%的人愿意支付最多 50 南苏丹镑（1 美元=10 南苏丹镑）的医疗咨询、实验室服务和药品保费。影响受访者决定的主要因素是意识、个人收入的其他来源、家庭规模、保险范围和宗教。
结论
支付意愿主要受意识、个人收入的其他来源、家庭规模、保险范围和宗教的影响。大多数公务员意识到并愿意为 NHIF 支付费用，并倾向于支付不超过总收入 5%的保费。除了对其他利益相关者进行详细分析外，还需要提高认识并接触那些不了解该计划的人。南苏丹政府可以考虑尽早启动该计划，因为大多数受访者都愿意为此做出贡献。
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