Willingness to Pay for Health Insurance among Informal Sector Workers: A Case Study from Hanoi Capital Vietnam

Huyen Thi Thu Doan, Minh Van Hoang


Objective: The aim of the study was to assess the individual’s willingness to pay (WTP) for health insurance among informal sector workers in urban areas of Viet Nam and to examine the effects of socio-economic factors on the WTP. Methods: The contingent valuation method, using the iterative biding game technique and final open-ended question, was used to elicit willingness to pay (WTP) for health insurance among informal sector workers. A two-stage cluster sampling technique was used to randomly select 300 informal sector workers aged 18-60 years working in the 4 inner districts of Hanoi. Results: 48.4% of respondents were willing to pay for health insurance. On average, people were willing to pay about 51 thousand VND per month (equivalent to 2.50 USD). The males’ willingness to pay was higher than females (57.4 thousand VND versus 47.6 thousand VND). The significant factors that affected on the rate and amount of WTP were: 1) male gender, 2) education of the respondents; 3) economic status of the respodent’s households 4) having chronic disease. Conclusion: Less than half of informal sector workers in the study area were willing to pay for health insurance. The WTP of informal sector workers was affected by gender, economic status of households and health status of respondents. There was a tendency of adverse selection in health insurance among informal sector workers.


Contingent valuation; willingness to pay; health insurance; informal sector worker; Vietnam

Full Text:

Download PDF


International Labour Organization. Key Indicators of the Labour Market 8 (KILM 8): Employment in the informal economy 2011; http://kilm.ilo.org/manuscript/kilm08.asp.

Cling J-P, Razafindrakoto M, Roubaud Fo. The informal economy in Viet Nam. Hanoi, Vietnam: International Labour Office.

Jean-Pierre Cling, Lê Văn Dụy, Nguyễn Thị Thu Huyền, Phan Thị Ngọc Trâm, Mireille Razafndrakoto, François Roubaud. Shedding light on a huge black hole: the informal sector in Hanoi - Main fndings of the Informal sector survey (IS Survey) 2007. 2009.

Jean-Pierre Cling, Nguyễn Thị Thu Huyền, Nguyễn Hữu Chí, Phan Thị Ngọc Trâm, Mireille Razafindrakoto, Roubaud F. The Informal Sector in Vietnam. A focus on Hanoi and Ho Chi Minh City. The Gioi ed2010.

Hanoi National Economics University. Research on informal employment in Viet Nam: current situation and solution. 2011.

National Assembly. Law on Health insurance, No: 25/2008/QH12 Hanoi2008.

Tống Thị Song Hương. Báo cáo về Chính sách Bảo hiểm Y tế ở Việt Nam Hội thảo Kinh tế Y tế Việt Nam năm 2012, Hải Phòng, Việt Nam2012.

Emma Mcintosh. Applied Methods of Cost - Benefit Analysis in Health Care. Oxford University Press; 2010.

Diener A, O'Brien B, Gafni A. Health care contingent valuation studies: a review and classification of the literature. Health Econ. 1998 Jun;7(4):313-326.

Olsen, Smith. Theory versus practice: a review of "willingness to pay in health and health care". Health Economics. 2001;10:39-52.

Dale Whitington. Administering Contigent Valuation Surveys in Developing Countries. World Development. 1998;26(1):21-30.

FAO. Applications of the contingent valuation method in developing countries. FAO Information Division ed2000.

Frew EJ, Wolstenholme JL, DK W. Comparing willingness-to-pay: bidding game format versus open-ended and payment scale formats. Health Policy. 2004;68(3):289-298.

Dong H, Kouyate B, Cairns J, R. S. A comparison of the reliability of the take-it-or-leave-it and the bidding game approaches to estimating willingness-to-pay in a rural population in West Africa. Soc Sci Med. 2003;56(10):2181-2189.

Onwujekwe O, Okereke E, Onoka C, Uzochukwu B, Kirigia J, Petu A. Willingness to pay for community-based health insurance in Nigeria: do economic status and place of residence matter? Health Policy Plan. 2010 Mar;25(2):155-161.

Gustafsson-Wright E, Asfaw A, Van der Gaag J. Willingness to Pay for Health Insurance: An Analysis of the Potential Market for New Low Cost Health Insurance Products in Namibia Soc Sci Med. 2009 Nov;69(9):1351-1359.

Donfouet HP, Makaudze E, Mahieu PA, E M. The determinants of the willingness-to-pay for community-based prepayment scheme in rural Cameroon. Int J Health Care Finance Econ. 2011 Sep;11(3):209-220.

Bärnighausen T, Liu Y, Zhang X, Sauerborn R. Willingness to pay for social health insurance among informal sector workers in Wuhan, China: a contingent valuation study. BMC Health Serv Res. 2007 Jul 20(7):114.

Asenso-Okyere WK, Osei-Akoto I, Anum A, Appiah EN. Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation. Health Policy. 1997 Dec;42(3):223-237.

Vuong Mai Lan. Gender difference in Willingness to pay for community based Health Insurance schemes in rural area, Vietnam. Umea: Public Health and Clinical Medecin, Umea University; 2005.

Dong H, Kouyate B, Snow R, Mugisha F, Sauerborn R. Gender's effect on willingness-to-pay for community-based insurance in Burkina Faso. Health Policy. 2003 May;64(2):153-162.

Dror DM, Radermacher R, Koren R. Willingness to pay for health insurance among rural and poor persons: field evidence from seven micro health insurance units in India. Health Policy. 2007 Jun;82(1):12-27.

Dong H, Kouyate B, Cairns J, Mugisha F, R. S. Willingness-to-pay for community-based insurance in Burkina Faso. Health Econ. 2003;12(10):849-862.

Curt Lofgren, Nguyen X Thanh, Nguyen TK Chuc, Anders Emmelin, Lars Lindholm. People's willingness to pay for health insurance in rural Vietnam. BioMed Central. 2008;6(16).