Willingness to Pay for Social Health Insurance Among Teachers at Governmental Schools in Gondar Town, Northwest Ethiopia

Abstract

Background: Globally, about 1.3 billion people lack access to effective and affordable healthcare and 150 million people in 44 million households face financial catastrophe. Health insurance schemes are an effective financing mechanism to help people who are unable to use healthcare services. However, the government employee’s Willingness to Pay (WTP) for the proposed premium for health insurance were not well investigated. Methods: A facility-based cross-sectional study was conducted from April to May, 2018 among teachers at governmental schools of Gondar town. The participants were selected using a simple random sampling technique using their payroll list as a sampling frame. Data were cleaned, coded, and entered into EPI-INFO version 7 software and exported to SPSS version 20 for analysis. A P-value less than 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were used to identify variables significantly associated with the outcome variable. Results: Overall, 62.0% of teachers were willing to pay 3% or more of their monthly salary for SHI. In this study, teachers whose monthly salary was more than US$215.6 (AOR=2.12; 95% CI=1.07– 4.17), first degree (AOR=4.44; 95% CI=2.89– 6.83), masters (AOR=4.91; 95% CI=1.14– 11.09), history of illness in the past 6 months (AOR=2.13; 95% CI=1.37– 3.31), not facing difficulty covering medical bills (AOR=0.49; 95% CI=0.35– 0.84), heard about SHI (AOR=1.73, 95% CI=1.09– 2.73), and favorable attitude towards SHI (AOR=1.82; 95% CI=1.22– 2.72) were significantly associated with WTP for the proposed price of the scheme. Conclusion: The majority of teachers were WTP the proposed amount of premium for the scheme. Factors such as level of education, monthly salary, attitudes, difficulty of covering medical bills, information, and history of illness were significantly associated with WTP for SHI. Therefore, awareness creation (sensitization activities) about SHI and increasing the educational status of the participant could improve WTP.