Assessment of willingness to pay for health insurance benefits and associated factors among commercial motorcycle riders in Dar es salaam- Tanzania

Abstract

ABSTRACT Background information: In Tanzania like many developing countries, injuries due to motorcycle accidents represent a major public health problem resulting in high cost of health care among the commercial motorcyclists accident victims in Tanzania. Most of these victims spend exorbitant amount of money for treatment that takes a long duration, most of the risk involving money in case of an accident as not protected by any prepayment mechanisms. Literatures have been done on motorcycle accidents and risk taking behaviors relating to payment of hospital cost and reduction of catastrophic expenditures among motorcycle riders. There is knowledge gap on exploring willingness to pay (WTP) for Health Insurance benefits and associated factors among Commercial Motorcycle riders in Dar es Salaam, as the option to reduce the out of pocket payment. Aim: The study aimed at exploring WTP for health insurance benefits as a health financing option and its associate factors (Socio-economic and demographic, health insurance benefit packages, premiums) among commercial motorcycle riders in Dar es n Salaam, and how it might be influenced by insurance related factors. Methodology: A cross sectional descriptive study was using Contingent valuation methods (CVM) using Take It or Leave It (TIOLI) and open ended elicitation techniques with follow up questions was applied to determine the extent of willingness to pay for health insurance and associated factors among respondents. A sample of representatives was selected from their parking stations in Ilala Municipal. A scenario, elicitation and individuals characteristics questions was presented in a face to face interview with the respondent. Sampling methods: Sample size of this study was 423. A random sampling was used to select 20 commercial motorcycle parking stations in Ilala Municipal during the working hours at the time of data collection. The list of parking areas was obtained from the respective authorities and was used as sample frame. The parking areas was randomly selected while 423 respondent was picked randomly from the box or table of random numbers. Data analysis was done using SPSS version 24.0; Distribution of WTP was explored, mean, and median and range were determined, multiple regression (logistic) was applied to determine and explore the determinants of WTP in descriptive statistical value. Results: Almost total of 423 respondents were interviewed, among them 95.7% were willing to pay for health insurance themselves and 77.8 % their willing to pay for themselves and their dependents for medical costs. The mean was TZS 62,500/= median was TZS 76,000/= and maximum WTP for health insurance was TZS 300,000/= as premium for health insurance per one person per years. There was statistical significant association between willingness to pay for health insurance and socio-economic and demographic characteristics (age, education, and employment status, risk taking behaviors, income and information asymmetry There was statistical significant association between maximum willingness to pay for health insurance benefit and risk taking behavior, awareness of health insurance benefits, insurance coverages and altruism (Willingness to include other peoples from principal member health insurance benefit package). Conclusion and recommendations: Majority of respondents were willing to pay for health insurance benefits package and the mean was TZS 62,500/= median was TZS 76,000/= and maximum WTP for health insurance was TZS 300,000/= as premium for health insurance per one person per years. Further studies must be conducted to investigate other determinants of WTP for health insurance benefits packages to commercial motorcycle riders, because this group of population is growing rapidly. There is a need of special attention to strategize effective plan of health promotion, provision and protection as the means toward universal health coverage to all by promoting pre payments mechanism while reducing out of pocket payments and catastrophic expenditures among commercial motorcycle riders