Socio-Demographic Predictors of Willingness to Pay for Premium of National Health Insurance: A Cross-sectional Survey of Six Districts in Sierra Leone

Document Type : Original Article


1 Department of Health Policy Management and Economics, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana

2 University of Makeni (UNIMAK), Makeni, Sierra Leone

3 College of Nursing and Midwifery, Nalerigu, Ghana

4 Sierra Leone Ministry of Health and Sanitation, Makeni, Sierra Leone

5 Medicine San Frontières (MSF), Makeni, Sierra Leone


The government of Sierra Leone introduced Social Health Insurance Scheme as a measure to remove financial barriers that beset the people in accessing health to ensure universal coverage. Under this policy, the citizens were encouraged to subscribe to the scheme to avoid out of pocket payment for healthcare at the point of use. This study was conducted to find out the predictors of willingness among the people to pay for health insurance premium. 
A cross-sectional study design was employed in six selected districts in Sierra Leone. Quantitative data was collected for this study through the use of semi-structured questionnaire with a sample size of 1185 respondents. Data was analysed into descriptive and inferential statistics using the contingent valuation model. Statistical analysis was run at 5% significant level using Stata version 14.0 software. 
The results showed that majority of the respondent are willing to join and pay a monthly premium of Le 10 000 (US$1.03) with an estimated mean contribution of about Le 14 089 (US$1.44) and the top five predictors of willingness to pay (WTP) were household monthly income, age, district of resident, gender, and educational qualification. 
The findings on predictors of WTP premium of Sierra Leone National Social Health Insurance (SLeNSHI), suggests that the socio-demographic characteristics of the population are important in premium design and payment. Efforts at improving the socio- economic statuses of the population could be helpful in premium design and payment.


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Volume 11, Issue 8
August 2022
Pages 1451-1458
  • Receive Date: 16 September 2020
  • Revise Date: 17 April 2021
  • Accept Date: 19 April 2021
  • First Publish Date: 26 May 2021