title: Exploring the threshold premium for viable community based health insurance schemes in Nigeria.
abstract: BACKGROUND
  The national health insurance scheme of Nigeria recently proposed a national premium for community based insurance scheme. This study determined the capacity of households in the rural and urban areas in Nigeria to pay for the premium and different hypothetical health insurance schemes namely national health insurance scheme, national urban health insurance scheme, national rural health insurance scheme and regional health insurance schemes. It determined the likely impact of different premiums on membership across socio-economic status quintiles, and then determined the threshold premium affordable to rural and urban households.
  
  
  RESULTS
  The results show that the mean capacity to pay for the households in different regions ranged from US$194 ± 100 to US$986 ± 907. The threshold premiums of the national health insurance scheme, urban national health insurance and rural health insurance schemes were US$66, US$154 and US$53 respectively.
  
  
  CONCLUSIONS
  Overall, the threshold premium for rural national health insurance scheme and national health insurance schemes were affordable to the lowest socio economic group. Hence, it is recommended that threshold premium for rural national health insurance scheme be adopted as the maximum premium not to be exceeded in the proposed national health insurance scheme.
authors.affiliation: Department of Surgery, Faculty of Medicine, College of Medicine, University of Nigeria, Nsukka, Nigeria. emeka.udeh@unn.edu.ng.
authors.forename: Emeka Ihechi
authors.initials: EI
authors.lastname: Udeh
authors.affiliation: Department of Health Administration and Management, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria.|Department of Pharmacology and Therapeutics, Faculty of Medicine, College of Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Obinna Emmanuel
authors.initials: OE
authors.lastname: Onwujekwe
authors.affiliation: Department of Community Medicine, Bowen University of Ibadan, Ibadan, Nigeria.
authors.forename: David Ayobami
authors.initials: DA
authors.lastname: Adewole
authors.affiliation: Department of Community Medicine, Faculty of Medicine, College of Medicine, University of Nigeria, Nsukka, Nigeria.
authors.forename: Chima Ariel
authors.initials: CA
authors.lastname: Onoka
mesh_terms: D003153:Community Health Services / Q000191:economics*; D005191:Family Characteristics; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D009313:National Health Programs / Q000191:economics*; D009549:Nigeria; D012423:Rural Health / Q000191:economics*; D012424:Rural Population; D012923:Social Class; D014504:Urban Health / Q000191:economics*; D014505:Urban Population
keywords: Community based health insurance scheme; National health insurance scheme; Threshold premium