Willingness to pay for children health insurance benefits among parents/guardians in Mbeya city

Abstract

ABSTRACT Background: Tanzania is like Many other developing countries, that out of pocket still contributing the large percent of the in the health financing mechanisms. Out of pocket expenditure that parents/guardians spend on the consultation, transportation, medicines, admission are pushing them especially those vulnerable group to a poverty and create barrier for primary health utilization for children. Tanzania introduced Toto afya Card as the solution for reducing health expenditure, how ever since its initiation parent’s/ guardians’ perceptions related to willingness to pay for Toto afya card to reduce out of pocket costs has not been explored Objective: The study aimed at assessing willingness to pay for Toto Afya Card among parents/guardians in Mbeya city. Design and methods: A cross sectional descriptive study was used to describe factors associated with willingness to pay. Study used Contingent valuation methods to elicit willingness to pay, take it or leave it (TIOLI) and open-ended technique with follow up questions are among four contingent valuation techniques that were used to estimate willingness to pay. A simple random sampling was used to select one study ward from the 36 total wards in the city. On arriving to the selected ward all the street in a particular ward total of eight streets was included in the study. In arriving to a street, a random systematic sampling strategy was used to select the 51 or 52 households in every street by skipping two households after each sampled house. In case a household was found to have more than one parent/ guardian with a child under 18 they were both included in a study.A questionnaire with structured questions was used to collect data on the parent’s/guardians’ willingness to pay, perceptions toward health insurance, child health expenditure and the socio-economic factors. Results: High proportional of male 88.3% were more willing to pay than female. Maximum willingness to pay ranged from TZS (1,000–100,000), with mean maximum willingness to pay of TZS 41,877.97 (SD 16,818.26). Among all perception statement, information about Toto Afya Card in the community scored lowest mean of 3.74 (SD 0.95). Among all statement, statement with insurance children can archive their dreams with good health scored high mean score of 4.56 9(SD 0.62). Results from ordinary least square shows that education and the monthly income were the socio-economic factors associated with willingness to pay. Results from logistic regression shows that education, occupation and monthly income were the socio-economic factors associated with willingness to pay. Conclusion: The average maximum willingness to pay found in this study was TZS 41,877.97 and median TZS 40,4000 lower compared to the actual premium of the TotoAfya Card.Respondents agreed to the importance of children health insurance scheme and how it save child’s medical expenditure. High health expenditure create a barrier for the child access the health services especially to the families with low income. Socio economic factors (income and education, ) influenced parents/guardians’ willingness to pay for Toto Afya Card.