The feasibility of community-based health insurance in Burkina Faso.
To ensure the acceptability of community-based insurance (CBI) by the community and its sustainability, a feasibility study of CBI was conducted in Burkina Faso, including preference for benefit package of CBI, costing of health services, costing of the benefit package and willingness-to-pay (WTP) for the package. Qualitative methods were used to collect information about preferences for the benefit package. Cost per unit health services, health demand obtained from household survey and physician-judged health needs were used to estimate the cost of the benefit package. The bidding game method was used to elicit household head's WTP for the package. We found that there were strong preferences for inclusion of high-cost healthservices such as operation, essential drugs and consultation fees in the benefit package. It is estimated that the cost of the package per capita was 1673 CFA (demand-based) and 9630 CFA (need-based), including 58% government subsidies (euro 1 = 655 CFA). The average household head with eight household members agreed to pay from 7500 (median) to 9769 CFA (mean) to join the CBI for his/her household. The WTP results were influenced by household characteristics, such as location, household size and age composition. Under certain assumptions (household as the enrolment unit, median household head's WTP as premium for the average household, 50% enrolment rate), it would be feasible to run CBI in Nouna, Burkina Faso if enrolees' health demand did not increase by more than 28% or if the underwriting of the initial losses was covered by extra funds.
Department of Tropical Hygiene and Public Health, University of Heidelberg, Im Neuenheimer Feld 324, D-69120 Heidelberg, Germany. donghengjin@yahoo.com
Hengjin
H
Dong
Frederick
F
Mugisha
Adjima
A
Gbangou
Bocar
B
Kouyate
Rainer
R
Sauerborn
D000367:Age Factors; D001294:Attitude to Health; D002050:Burkina Faso; D003153:Community Health Services / Q000191:economics*; D003258:Consumer Behavior / Q000191:economics*; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005240:Feasibility Studies; D005249:Fees and Charges; D005260:Female; D005382:Financing, Personal; D006302:Health Services Research; D006801:Humans; D007342:Insurance Benefits; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D010865:Pilot Projects; D012959:Socioeconomic Factors