Paying for community-based health insurance schemes in rural Nigeria: the use of in-king payments

Financing healthcare for the poor is one major challenge facing the world’s poorest populations in developing countries. While over 90% of the global burden of disease is borne by over 80%, only about 11% of global health spending is on the poor. Community-based health insurance schemes (CBHIS) have emerged in Africa for mobilizing community resources. They can also be a stepping stone to a more formal and potentially universal coverage. In parts of Africa where such schemes exist, they have not effectively covered the target population. Nigeria has a few such schemes. This paper uses the contingent valuation to examine the possibility of adopting CBHIS using in-kind payments in rural Nigeria. The study finds that gender, household size, health status, the quality of health care centers, confidence in the proposed scheme, distance to the nearest health care center and income are major determinants of households’ willingness to pay (WTP) for the scheme.