Post conflict fragile states have issues in their health care systems that are demanding constant and continuous support from many developed countries and from the World Bank and International Monetary Fund. Post conflict fragile states have higher rate of infectious and communicable diseases. Such countries were predicted to lose (20%) twenty percent of their national revenue. Their economic growth will shrink between ($ 1.4 and $ 2.8) billion (Schieber, et al., 2006, p. 2).
Budget for health care system in post conflict South Sudan is declining from 7% to 4% percent. The Abuja conference in 2001 declared that each country in Africa to increase health budget by 15% per cent. Only six countries managed to meet this target. Despite post conflict fragile state South Sudan had zero debts during those years.
The demand for health care services is on the rise with rise in diseases as the population growths. This will require additional funds to cover the costs of healthcare services. It is pertinent to reflect into the Alma Ata (WHO, September 1978) declaration of primary health care with the agenda of sections: -
(4) The people have the right and duty to participate individually and collectively in the planning and implementation of their health care.
(5) Government has the responsibility of its health care system and primary health care is the norm for achieving a vibrant social and productivity society.
There is a growing and promising growth in the economic sectors of post conflict fragile state South Sudan. There are South Sudanese in the rural areas that used to pay tax from share of their agricultural output. This payment of tax as a share of goods was very common among the Bari tribe. Social health insurance as a financing mechanism in a chronically underfinanced health system is receiving much attention (GTZ/ILO/WHO 2006a, Carrin & James, 2004; WHA, 2005). The informal sector too (GTZ/ILO/WHO, 2006b) stated in (Mathauer, et al., 2008) is a focal point.
South Sudan is one of the Post Conflict countries and is a Fragile State (Aime 2008, Carment and Samy 2011, Olowu and Chanie 2016). Fragile State was a state that had capabilities of funding itself through its own capital, as Adam Smith (1776) defined capital in “Wealth of Nation”, and had the abilities of operating and running its own affairs to some satisfactions of her population.
Healthcare budget for Post Conflict Fragile State South Sudan has been declining from 7 % to 4 % per cent, since 2008. Only six African countries met the Abuja declaration of dedicating 15 % per cent of their budget for healthcare. International healthcare funding has been trickling and accessibility to healthcare services is difficult occasionally (Bräutigam and Knack 2004, Cometto, Fritsche et al. 2010, Varela, Cali et al. 2016, Roberts, Guy et al. 2017). Mortality rate in post conflict fragile state South Sudan is (8) eight times the world average. Under funded healthcare system can increase mortality rates, (Lockman, et al., 2003; Walsh & Kenneth, 1980, p. 147). Besides, there are households who cannot afford to cover their medical costs (Erasmus and Nkoroi 2002).
Funding healthcare through employer and employee contribution; either public or private mixed can alleviate health of the local population (Mathauer, Schmidt et al. 2008). Philippines implemented social health insurance despite economic hurdles (Obermanna, Jowettb et al. 2006). Social health insurance and its variants were found to be effective in several countries (Spaan, Mathijssen et al. 2012).
Health Believed Model (HBM)
This research was in contrast to researches that used (WTP) in contingent valuation method over an assumed gaming scenario. Adopting gaming scenario increases the cognitive error term of respondents. This is because there exists a gap between health issues outlaid and the sudden presentation of (WTP). But when health scenario is presented in direct association with health and medical costs, human cognition becomes more focused on the expected behavioral outcome.
Health Believed Model is the application of a measured human behaviour; mostly on health and medicine. The concept of cognitive theory in health is also related to the collective actions needed in insurance (Bandura 2000, Bandura 2001). Twenty nine (29) studies had substantially adopted the health believed model (HBM) (Janz and Becker 1984). A number of researchers suggested that our behaviour is both qualitative and quantitative (Bandura 2000, 2001, 2004, Ogden 2007). These behaviours are grounded on the expected value and subjective utility theory (Peak 1955). Mckenna (1996) stated that the outcome of the different cognitive behaviour when sum over a population will lead to a desired outcome (Conner 1993).
Households are susceptible to health risks and will take any measures to remain healthy (Moore and W. Kip Viscusi 1989). Skilful and educated workers will certainly demand protection from their employers to minimise future health risk and its effects (Iversen and Sosicice 2001). Public and self-employed differ in their health risks behaviour (Atella and Rossi 2005). Cueing to health protections varies between households and the severity of the ailments (Rosenstock, Strecher et al. 1988).
On many occasions, ill health is perceived as a threat in our societies. Inoculating the family with remedies for a healthy body has become part of our norms. Sudden illness sparks sense of illness affecting. Households cue to providing medical treatments (Morrman and Matulich 1993). Besides, households are inspired from successful treatments. This cue household into willingness to pay for their health. But, lack of proper income streams and pecuniary, may refrained some households from providing medical treatments. Our desire to raise family through achievement in the community; enhances believes in treatment helping illness (Gelb and Gully 1979). Believes in the outcome of willingness to pay (WTP) from several households can lead to financing of social health insurance.
Life expectancy will rise higher when the independent variables were positively observed by the individuals (Cichon, Newbrander et al. 1999). Communal life in Post Conflict Fragile State South Sudan will cue into a common life goal.
Body resistance always on prescription should indicate risk and vulnerability in someone's health. Those who “cannot tell” their resistance to illness and had had previous health as “unknown” were expected to cue for (SHI). Similarly, health outlook, "I do not know" is a risky health behavior because previous health should have mediated their cognition.
Sickness situation as "None" is a risky behavior because life, illness and death are events with natural certainties that bear expectations. Sickness respond as "Neutral" is a risky behavior because the expectation from being sick is to cue to action. Responses of “seeking medical attention” are expected to propagate into health benefits of (WTP). While illness affecting is to moderate believes in positive health outcomes. Believes in positive health outcome are expected to rise along the scale of treatment helping illness (Fletcher, Morgan et al. 1989).