The challenges of development in Africa are enormous. While the population still strive to tackle the
problem of widespread poverty, the issue of health care payments for the poor has remained largely
a problem in most parts of Africa. In Nigeria, the case is no different. In most parts of Africa, health
care payments still remain out-of-pocket payments or payment at the point of utilization. The poor
who are constrained by their level of earnings and the nature of lifestyle cannot afford to make such
payments at the point of utilization. The paper in this regard examines the option of using
community based insurance schemes for rural communities in Nigeria as an option to safeguard
them from the high cost of health care through out-of-pocket expenditure. It proposed the use of
in-kind payments in the form of agricultural commodities. Specifically, the contingent valuation
methodology was employed to value the willingness of households in rural communities to pay for
community health insurance scheme. The results show that rural communities are very willing to
participate and to pay for the scheme that is aimed at reducing the unpredictability in ‘forced’ outof-pocket
health care payments. Since the rural poor do not have access to formal insurance
schemes, these community contributory schemes are likely to be a start-off. Funds can be pooled
together when the households can afford payments then payment for health care services will
become relatively predictable.