{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T11:38:16Z","timestamp":1773315496943,"version":"3.50.1"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>High out-of-pocket expenditures (OOPE) continue to make access to healthcare a challenge among informal sector workers in most low-income countries. In response, Uganda has proposed a national health insurance scheme (NHIS), although the informal sector\u2019s willingness and ability to pay for it remains unexplored. This study assessed the willingness and perceived ability to pay for the proposed NHIS, along with their determinants, among informal sector workers in Iganga and Mayuge Districts, Uganda. A cross-sectional study was conducted in Iganga and Mayuge Districts between April and May 2019. A contingent valuation method using the bidding game technique was used to elicit the willingness to pay (WTP). A total of 853 informal sector workers were randomly selected and all interviewed (100% response rate). Seven focus group discussions (FGDs) were also conducted. Logistic regression analysis was done to identify the determinants of WTP for the proposed NHIS. Qualitative data were analyzed thematically. The majority 695\/853, (81.5%) and 633\/853, (74.2%) of the respondents were willing and believed that they would be able to pay for NHIS, respectively. The median WTP was UGX 25,000 (USD 6.8) annually. WTP was significantly associated with being a fisherfolk (AOR: 1.70 95%CI: 1.04-2.79, P\u2009=\u20090.035), being in the fourth wealth quintile (AOR: 2.98, 95% CI: 1.56\u20135.65), \u201cnot having heard\u201d about health insurance (AOR: 0.50 95%CI: 0.23-0.86, P\u2009=\u20090.032), and \u201cnot having membership in a savings group\u201d (AOR: 0.51, 95%CI: 0.34-0.76, P\u2009&lt;\u20090.001). Most FGD participants reported willingness to pay for the proposed scheme; however, some doubted their ability to do so due to extreme poverty levels and unstable income. The WTP for the proposed NHIS in the informal sector was high. However, raising awareness and considerations for the indigent when setting appropriate premiums should be a priority.<\/jats:p>","DOI":"10.1371\/journal.pgph.0003603","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:27:22Z","timestamp":1773250042000},"page":"e0003603","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Willingness and perceived ability to pay for Uganda\u2019s proposed national health insurance scheme among informal sector workers in Iganga and Mayuge districts, Uganda: A contingent valuation method"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0025-2753","authenticated-orcid":true,"given":"Noel","family":"Namuhani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela N.","family":"Kisakye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne N.","family":"Kiwanuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"pgph.0003603.ref001","volume-title":"Universal health coverage (UHC): World Health Organization","author":"WHO","year":"2023"},{"key":"pgph.0003603.ref002","volume-title":"Health systems financing: the path to universal coverage","author":"WHO","year":"2010"},{"key":"pgph.0003603.ref003","year":"2010"},{"key":"pgph.0003603.ref004","volume-title":"Noncommunicable diseases: World Health Organization","author":"WHO","year":"2024"},{"key":"pgph.0003603.ref005","year":"2025"},{"issue":"6","key":"pgph.0003603.ref006","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3390\/economies13060149","article-title":"Health expenditure shocks and household poverty amidst COVID-19 in Uganda: how catastrophic?","volume":"13","author":"D Mpuuga","year":"2025","journal-title":"Economies"},{"key":"pgph.0003603.ref007","unstructured":"MoH. 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