Adoption of Mobile health Insurance Systems in Africa: evidence from Cameroon

The cost of health care services remains central concerns in low- and middle-income countries (LMIC), especially in Africa. One of the major challenges they face is how to efficiently reduce out-of-pocket spending. Health insurance systems are either inexistent or inefficient in many of these countries. In an attempt to implement and improve these systems, several countries have implemented mobile-supported health insurance systems (MHIS). Unfortunately, most of these programs have not crossed the pilot phases because of low adoption rates. Thus, this study sought to investigate the factors that influence the adoption of MHIS in LMIC. Using 263 valid responses collected during a 3-month survey in Cameroon, we found that coping appraisal and technology appraisal are important for the adoption of MHIS in LMIC. Precisely, performance expectancy, self-efficacy, response efficacy, facilitating conditions, and perceived cost explain 57.7% of the variance in behavioral intention to adopt MHIS. This study is based on empirically tested factors founded on the protection motivation theory (PMT) and the unified theory of acceptance and use of technology (UTAUT). Our contributions target health economists, technologists, policymakers, managers, researchers, and anyone interested in understanding the behavior of health insurance service consumers in LMIC and the pressures insurers and governments face during MHIS programs. We discuss the implications of our findings and further research that could help further explain MHIS adoption in LMIC.