[Health care microinsurance in Katako-Kombe, DRC: constraints and challenges].

CONTEXT: The WHO estimates that 100 million people are pushed into poverty by direct payments for medical services. This work explored the constraints and challenges for setting up health microinsurance in a developing country, the Democratic Republic of Congo (DRC).

METHODS AND MATERIALS: This is a cross-sectional, analytical, quantitative, and household survey based on two-stage cluster sampling. Data entry was done using the EPI DATA software and analysis by the SPSS software.

MAIN

RESULTS

The average income per capita in DRC 119.35 USD per year. The total amount was USD 3.87 for a disease episode. The average cost paid for health care at the last episode of illness was 5.91 USD. Just over six out of ten households (64.43%) felt that health care was too expensive.Nearly nine out of ten households would be willing to subscribe to a microinsurance health plan, even though four out of ten households felt the premium was exorbitant (US $ 6.65 per person per year). The willingness to pay for the contribution to a voluntary health insurance scheme was $5.16 per household per year, or $0.71 per person.

CONCLUSION

We have shown that universal coverage with an expanded package of offered services is not economically feasible in the health zone of Katako-Kombe, through the establishment of a quality health micro insurance, if it relies only on the contributions of its members.