title: Acceptability of, and willingness to pay for, community health insurance in rural India.
abstract: OBJECTIVE
  To understand the acceptability of, and willingness to pay for, community health insurance coverage among residents of rural India.
  
  
  METHODS
  We conducted a mixed methods study of 33 respondents located in 8 villages in southern India. Interview domains focused on health-seeking behaviors of the family for primary healthcare, household expenditures on primary healthcare, interest in pre-paid health insurance, and willingness to pay for such a product.
  
  
  RESULTS
  Most respondents reported that they would seek care only when symptoms were manifest; only 6 respondents recognized the importance of preventative services. None reported impoverishment due to health expenditures. Few viewed health insurance as necessary either because they did not wish to be early adopters, because they had alternate sources of financial support, or because of concerns with the design of insurance coverage or the provider. Those who were interested reported being willing to pay Rs. 1500 ($27) as the modal annual insurance premium.
  
  
  CONCLUSIONS
  Penetration of community health insurance programs in rural India will require education of the consumer base, careful attention to premium rate setting, and deeper understanding of social networks that may act as financial substitutes for health insurance.
authors.affiliation: IKP Centre for Technologies in Public Health, A2, Amsavalli Illam, 7th Cross Street, Arulananda Nagar, Thanjavur 613007, India.
authors.forename: Ankit
authors.initials: A
authors.lastname: Jain
authors.affiliation: IKP Centre for Technologies in Public Health, A2, Amsavalli Illam, 7th Cross Street, Arulananda Nagar, Thanjavur 613007, India.
authors.forename: Selva
authors.initials: S
authors.lastname: Swetha
authors.affiliation: IKP Centre for Technologies in Public Health, A2, Amsavalli Illam, 7th Cross Street, Arulananda Nagar, Thanjavur 613007, India.
authors.forename: Zeena
authors.initials: Z
authors.lastname: Johar
authors.affiliation: Washington University in St. Louis, Brown School, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA. Electronic address: raghavan@wustl.edu.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Raghavan
mesh_terms: D000328:Adult; D003906:Developing Countries; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007194:India; D007348:Insurance, Health / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D012423:Rural Health / Q000191:economics*; D019035:Rural Health Services / Q000191:economics* / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Acceptability; Community health insurance; Health insurance; India; Rural health
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