Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation.

In the midst of high cost of health care both at the macro and micro levels, health insurance becomes a viable alternative for financing health care in Ghana. It is also a way of mobilising private funds for improving health care delivery at the macro level. This study uses a contingent valuation method to assess the willingness of households in the informal sector of Ghana to join and pay premiums for a proposed National Health Insurance scheme. Focus group discussions, in-depth and structured interviews were used to collect data for the study. There was a high degree of acceptance of health insurance in all the communities surveyed. Over 90% of the respondents agreed to participate in the scheme and up to 63.6% of the respondents were willing to pay a premium of 5000 cents or $3.03 a month for a household of five persons. Using an ordered probit model, the level of premiums households were willing to pay were found to be influenced by dependency ratio, income or whether a household has difficulty in paying for health care or not, sex, health care expenditures and education. As income increases, or the proportion of unemployed household members drop, people are willing to pay higher premiums for health insurance.

Livelihood and the risk of HIV/AIDS infection in Ghana: the case of female itinerant traders.

Itinerant trading is the second major economic activity for women who constitute an important chain in the distribution of goods in West Africa. Historically they have played important roles in the political economy of Ghana. With the outbreak of AIDS these women, some of whom move far away from home sometimes for days for even weeks, stand the risk of being infected with HIV through their activities. Using a combination of methods including a survey, focus-group discussions and conversations with key informants; we examine how the trade is organized, the characteristics of the traders, and the risk factors that are likely to predispose them to contracting the AIDS virus. Itinerant women traders appear highly vulnerable, as women and as highly mobile people. This state of affairs, occasioned by the extremely difficult conditions in which the women work, is exploited for the sexual gratification of the men with whom they come into contact. The attempt to reduce the spread of AIDs through education has to target itinerant women traders at the points of transaction.