City Research Online

Corruption and Health Insurance for the Informal Sector in Sierra Leone

Jofre-Bonet, M. ORCID: 0000-0002-2055-2166, Kamara, J. & Mesnard, A. ORCID: 0000-0001-6899-9138 (2021). Corruption and Health Insurance for the Informal Sector in Sierra Leone (21/01). London, UK: Department of Economics, City, University of London.


Most governments cannot provide the necessary health services required for their citizens either as a result of scarcity of resources or corruption (Mostert et al., 2012). Lack of credibility and trust in fund managers has been highlighted as one of the reasons why people do not join health insurance schemes in developing countries, especially in Africa (Escobar et al., 2010). This work investigates the impact of corruption on household’s willingness to participate and pay for health insurance in the presence of corruption. To do so, we use (1) a binary logit model to study the relationship between household characteristics and experienced corruption; (2) an ordered probit model to explore how household characteristics are associated to the intensity of corruption perceived; and (3) a Mixed Logit model to estimate the association of corruption and participation and willingness to pay for a health insurance scheme. We find that corruption decreases the willingness to participate and pay for a public Health Insurance Scheme (HIS). Comparing experienced and perceived corruption, we observe that experienced corruption affects less WTP for a HIS than perceived corruption. Households experiencing corruption, are willing to pay more for a public HIS than those that perceive high levels of corruption. The implications of our findings are in line with the literature and stress the perverse spillover effects of corruption. Not only corruption hinders the effectiveness of health care systems and thus health outcomes, but it also undermines the willingness to pay for them and thus imperils the sustainability of health care systems in the countries that are most in need of them.

Publication Type: Monograph (Discussion Paper)
Additional Information: Copyright, 2021, the authors.
Subjects: D History General and Old World > DT Africa
H Social Sciences > HC Economic History and Conditions
H Social Sciences > HF Commerce
H Social Sciences > HN Social history and conditions. Social problems. Social reform
H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Policy & Global Affairs > Economics
School of Policy & Global Affairs > Economics > Discussion Paper Series
Text - Published Version
Download (597kB) | Preview



Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login