Willingness to pay for National Health Insurance Services and Associated Factors in Africa and Asia: a systematic review and meta-analysis.

Autor:	Bayked EM; Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia., Assfaw AK; Department of Psychology, Institute of Teachers' Education and Behavioral Science, Wollo University, Dessie, Ethiopia., Toleha HN; Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia., Zewdie S; Department of Pharmacy, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia., Biset G; Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia., Ibirongbe DO; Department of Community Medicine, University of Medical Sciences, Ondo, Nigeria., Kahissay MH; Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2024 Apr 19; Vol. 12, pp. 1390937. Date of Electronic Publication: 2024 Apr 19 (Print Publication: 2024).
DOI:	10.3389/fpubh.2024.1390937
Abstrakt:	Background: Universal health coverage (UHC) is crucial for public health, poverty eradication, and economic growth. However, 97% of low- and middle-income countries (LMICs), particularly Africa and Asia, lack it, relying on out-of-pocket (OOP) expenditure. National Health Insurance (NHI) guarantees equity and priorities aligned with medical needs, for which we aimed to determine the pooled willingness to pay (WTP) and its influencing factors from the available literature in Africa and Asia. Methods: Database searches were conducted on Scopus, HINARI, PubMed, Google Scholar, and Semantic Scholar from March 31 to April 4, 2023. The Joanna Briggs Institute's (JBI's) tools and the "preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement" were used to evaluate bias and frame the review, respectively. The data were analyzed using Stata 17. To assess heterogeneity, we conducted sensitivity and subgroup analyses, calculated the Luis Furuya-Kanamori (LFK) index, and used a random model to determine the effect estimates (proportions and odds ratios) with a p value less than 0.05 and a 95% CI. Results: Nineteen studies were included in the review. The pooled WTP on the continents was 66.0% (95% CI, 54.0-77.0%) before outlier studies were not excluded, but increased to 71.0% (95% CI, 68-75%) after excluding them. The factors influencing the WTP were categorized as socio-demographic factors, income and economic issues, information level and sources, illness and illness expenditure, health service factors, factors related to financing schemes, as well as social capital and solidarity. Age has been found to be consistently and negatively related to the WTP for NHI, while income level was an almost consistent positive predictor of it. Conclusion: The WTP for NHI was moderate, while it was slightly higher in Africa than Asia and was found to be affected by various factors, with age being reported to be consistently and negatively related to it, while an increase in income level was almost a positive determinant of it. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Bayked, Assfaw, Toleha, Zewdie, Biset, Ibirongbe and Kahissay.)
Databáze:	MEDLINE
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