Corruption and informal sector households' participation in health insurance in Sierra Leone.

Lack of credibility and trust in fund managers has been highlighted as one of the key reasons why people do not join health insurance schemes in low- and middle-income countries, especially in Africa. This work investigates the impact of corruption on households' willingness to participate and...

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Main Authors: Mireia Jofre-Bonet, Joseph Kamara, Alice Mesnard
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0281724
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author Mireia Jofre-Bonet
Joseph Kamara
Alice Mesnard
author_facet Mireia Jofre-Bonet
Joseph Kamara
Alice Mesnard
author_sort Mireia Jofre-Bonet
collection DOAJ
description Lack of credibility and trust in fund managers has been highlighted as one of the key reasons why people do not join health insurance schemes in low- and middle-income countries, especially in Africa. This work investigates the impact of corruption on households' willingness to participate and pay for health insurance in Sierra Leone. A discrete choice experiment (DCE) method was used to elicit households' willingness to participate in a health insurance scheme with different attributes. The data were collected from 1458 representative households working in the informal sector of the Northern and Western regions. We explore the relationship between household characteristics and experienced (respectively, perceived) corruption with binary and ordered logit models. We use a Mixed Logit model to estimate the association between corruption and participation in a Health Insurance Scheme (HIS) and households' willingness to pay for a HIS. We find that corruption decreases participation in a public HIS and the willingness to pay for it. Our results highlight the perverse spillover effects of corruption. Not only does corruption hinder the effectiveness of healthcare systems and, thus, worsen health outcomes. It also undermines the willingness to pay for them, jeopardizing the sustainability of healthcare systems in the countries that need them most.
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spelling doaj.art-bb95db6a23e14f898dcee007c1b0e8c72023-04-27T05:31:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01184e028172410.1371/journal.pone.0281724Corruption and informal sector households' participation in health insurance in Sierra Leone.Mireia Jofre-BonetJoseph KamaraAlice MesnardLack of credibility and trust in fund managers has been highlighted as one of the key reasons why people do not join health insurance schemes in low- and middle-income countries, especially in Africa. This work investigates the impact of corruption on households' willingness to participate and pay for health insurance in Sierra Leone. A discrete choice experiment (DCE) method was used to elicit households' willingness to participate in a health insurance scheme with different attributes. The data were collected from 1458 representative households working in the informal sector of the Northern and Western regions. We explore the relationship between household characteristics and experienced (respectively, perceived) corruption with binary and ordered logit models. We use a Mixed Logit model to estimate the association between corruption and participation in a Health Insurance Scheme (HIS) and households' willingness to pay for a HIS. We find that corruption decreases participation in a public HIS and the willingness to pay for it. Our results highlight the perverse spillover effects of corruption. Not only does corruption hinder the effectiveness of healthcare systems and, thus, worsen health outcomes. It also undermines the willingness to pay for them, jeopardizing the sustainability of healthcare systems in the countries that need them most.https://doi.org/10.1371/journal.pone.0281724
spellingShingle Mireia Jofre-Bonet
Joseph Kamara
Alice Mesnard
Corruption and informal sector households' participation in health insurance in Sierra Leone.
PLoS ONE
title Corruption and informal sector households' participation in health insurance in Sierra Leone.
title_full Corruption and informal sector households' participation in health insurance in Sierra Leone.
title_fullStr Corruption and informal sector households' participation in health insurance in Sierra Leone.
title_full_unstemmed Corruption and informal sector households' participation in health insurance in Sierra Leone.
title_short Corruption and informal sector households' participation in health insurance in Sierra Leone.
title_sort corruption and informal sector households participation in health insurance in sierra leone
url https://doi.org/10.1371/journal.pone.0281724
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