Academic journal article Journal of Health Population and Nutrition

Factors Influencing People's Willingness-to-Buy Insecticide-Treated Bednets in Arbaminch Zuria District, Southern Ethiopia

Academic journal article Journal of Health Population and Nutrition

Factors Influencing People's Willingness-to-Buy Insecticide-Treated Bednets in Arbaminch Zuria District, Southern Ethiopia

Article excerpt

INTRODUCTION

Ethiopia is one of the countries in sub-Saharan Africa seriously affected by malaria. About three-fourths of the total area of Ethiopia is malarious, and an estimated 48 million people--68% of the population--live in areas with risk of malaria (1).

Cognizant of this, the Federal Ministry of Health has developed a national five-year strategic plan for the prevention and control of malaria in Ethiopia (2). The target of the strategic plan was to attain a 100% coverage of all households in malarious areas, with at least one insecticide-treated bednet (ITN) by 2007 and that at least 90% of children aged less than five years (under-five children) and pregnant women will be sleeping under ITNs by 2010 (2). The strategic plan is to be implemented by providing subsidies to those not able to pay and by charging fees for the remaining population. This is because, like many other African countries, the Government is adopting user-fees and promoting self-financing healthcare to help restore efficiency and equity to national health systems. User-fees in the public-health facilities help promote equity because the demand for healthcare rises disproportionately with income. People who are well-off are more able and willing to pay for costly services. So, charging wealthier people for service they demand and can afford and pooling those revenues to subsidize those least able to afford care is a way to improve healthcare-delivery to the poor (3). ITNs are new to many people, and many are vulnerable to malaria but are too poor to afford buying ITNs. The Government also cannot afford to give free nets to all. Hence, a subsidized ITN market needs to be established since subsidized sales of ITNs can effectively introduce the component of sustainability and self-reliance in the prevention of malaria.

Willingness- and ability-to-pay (WTP) refers both to preference and behaviour. The preference of consumers is formed based on three considerations: a consumer needs and desires; information about the existence and characteristics of a good or service and judgment about ones own probable benefit from that good or service relating to one's other needs and desires; and capacity to satisfy them, given the price and the cost of the transaction. Thus, when one speaks of studying the WTP for healthcare, one is talking about studying consumers' demand for healthcare services (4). Therefore, assessing the people's WTP for ITNs and the factors influencing it would generate vital information that can make important contribution to the evidence-based design of malaria-control policies and strategies.

The objective of the study was to assess the bednet possession of the community in Arbaminch Zuria district, determine the people's willingness-to-pay for ITNs, and identify what factors influence it.

MATERIALS AND METHODS

This cross-sectional community-based study was conducted in four randomly-selected malarious Kebeles of Arbaminch Zuria district of Gammo Gofa zone, southern Ethiopia. The study tool included a pretested interview-administered structured questionnaire. Two independent translators translated the questionnaire into the local language Gammogna, and the consistency was checked. The head of the household or one adult member representative of the study household was interviewed using the local language. Both data collectors and supervisors were able to speak the local language fluently. To assess the people's willingness-to-pay, contingent valuation using binary with follow-up method was used. The advantage, the distribution, and the payment mechanism were explained, and three different qualities of ITNs--one freely-distributed and two socially-marketed nets of different colours--were shown.

The two socially-marketed nets were conical in shape and, in terms of colour, one is white and the other one is blue. These nets were made available to the people with subsidized price by non-governmental organizations (NGOs) working in social marketing. …

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