ArticlePloS one2023
Corruption and informal sector households' participation in health insurance in Sierra Leone.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Health sector corruption and access to healthcare in Africa.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Administrative perspectives on the implementation and sustainability of state-supported health insurance schemes in Nigeria: a descriptive qualitative study.BMC public health · 2025Article
- Enhancing smart healthcare networks: Integrating attribute-based encryption for optimization and anti-corruption mechanisms.Heliyon · 2025Article
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Authors and funding
3 authors.
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Abstract
Lack of credibility and trust in fund managers has been highlighted as one of the key reasons why people do not join health insurance schemes in low- and middle-income countries, especially in Africa. This work investigates the impact of corruption on households' willingness to participate and pay for health insurance in Sierra Leone. A discrete choice experiment (DCE) method was used to elicit households' willingness to participate in a health insurance scheme with different attributes. The data were collected from 1458 representative households working in the informal sector of the Northern and Western regions. We explore the relationship between household characteristics and experienced (respectively, perceived) corruption with binary and ordered logit models. We use a Mixed Logit model to estimate the association between corruption and participation in a Health Insurance Scheme (HIS) and households' willingness to pay for a HIS. We find that corruption decreases participation in a public HIS and the willingness to pay for it. Our results highlight the perverse spillover effects of corruption. Not only does corruption hinder the effectiveness of healthcare systems and, thus, worsen health outcomes. It also undermines the willingness to pay for them, jeopardizing the sustainability of healthcare systems in the countries that need them most.
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