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Background <p>High out-of-pocket health expenditure is a significant barrier to the utilization of timely health care in rural villages. The aim of the current study is to analyse the perceptions of rural residents regarding the willingness to pay for a community-based health insurance scheme.</p> Methods <p>A community-based study was conducted among 374 rural participants in a border district of Punjab. Data were collected using multistage random sampling through face-to-face interviews with a structured questionnaire. Principal Component Analysis was used to calculate wealth quintiles, and participants were classified into three categories: rich, medium and poor. Descriptive statistics, double-bounded contingent valuation method and multiple logistic regression were applied to analyse the risk factors and associated outcomes.</p> Results <p>Out of 374 study participants, 241 respondents showed willingness to pay for health insurance scheme while,133 declined to opt community-based health insurance. Half of respondents agreed to pay the initial bid of 1,000 rupees for CBHI. The mean amount of premium that respondents were willing to pay in the first bid was 831 rupees. Respondents who had higher education level, belonged to medium and rich income class (AOR = 3.77, CI = 1.40–4.81, <i>p</i> &lt; 0.01), smaller household size coupled with chronic illness (AOR = 1.54, CI = 1.22–4.09, <i>p</i> &lt; 0.05) and perceived high health expenditure (AOR = 1.31, CI = 1.06–2.96, <i>p</i> &lt; 0.05) had a greater likelihood of opting community-based health insurance.</p> Conclusion <p>The study concludes that there is a substantial demand for community-based health insurance among rural households in border villages of Amritsar. Income, education, nuclear family size, prolonged chronic illness, perceived high cost of treatment and good health status were significant determinants associated with willingness to pay for community-based health insurance. To expand universal health coverage, it is important to develop and design effective community-based health insurance and micro insurance options with possible premium amount for rural communities. Strengthening awareness of community-based health insurance in rural areas can create mutual benefits by improving healthcare access, reducing self-medication risks and lowering out of pocket expenditure.</p>

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Willingness to pay for community-based health insurance among rural households in the border district of Punjab, India

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月30日

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  • Mandeep Kaur

摘要

Background

High out-of-pocket health expenditure is a significant barrier to the utilization of timely health care in rural villages. The aim of the current study is to analyse the perceptions of rural residents regarding the willingness to pay for a community-based health insurance scheme.

Methods

A community-based study was conducted among 374 rural participants in a border district of Punjab. Data were collected using multistage random sampling through face-to-face interviews with a structured questionnaire. Principal Component Analysis was used to calculate wealth quintiles, and participants were classified into three categories: rich, medium and poor. Descriptive statistics, double-bounded contingent valuation method and multiple logistic regression were applied to analyse the risk factors and associated outcomes.

Results

Out of 374 study participants, 241 respondents showed willingness to pay for health insurance scheme while,133 declined to opt community-based health insurance. Half of respondents agreed to pay the initial bid of 1,000 rupees for CBHI. The mean amount of premium that respondents were willing to pay in the first bid was 831 rupees. Respondents who had higher education level, belonged to medium and rich income class (AOR = 3.77, CI = 1.40–4.81, p < 0.01), smaller household size coupled with chronic illness (AOR = 1.54, CI = 1.22–4.09, p < 0.05) and perceived high health expenditure (AOR = 1.31, CI = 1.06–2.96, p < 0.05) had a greater likelihood of opting community-based health insurance.

Conclusion

The study concludes that there is a substantial demand for community-based health insurance among rural households in border villages of Amritsar. Income, education, nuclear family size, prolonged chronic illness, perceived high cost of treatment and good health status were significant determinants associated with willingness to pay for community-based health insurance. To expand universal health coverage, it is important to develop and design effective community-based health insurance and micro insurance options with possible premium amount for rural communities. Strengthening awareness of community-based health insurance in rural areas can create mutual benefits by improving healthcare access, reducing self-medication risks and lowering out of pocket expenditure.