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University of Cape Town (1998)

Willingness and ability to pay for insecticide : treated nets in Northern Ghana

Akweongo, Patricia

Titre : Willingness and ability to pay for insecticide : treated nets in Northern Ghana

Auteur : Akweongo, Patricia

Université de soutenance : University of Cape Town.

Grade : Master of Social Science 1999

Résumé
Insecticide treated nets (ITNs) are a highly cost-effective tool in malaria control and has been associated with reductions in morbidity and mortality in children. Even though their efficacy has been established, the success of their use as a malaria control tool depends on their effective implementation and sustainability. The purpose of this study was to assess factors that would impact on household willingness and ability to pay for insecticide treated nets in the Bolgatanga district of Northern Ghana to provide insights into the sustainability of this tool. The paper presents the results of a survey of 876 household heads from both the rural and urban areas of the district. The survey questionnaire was designed to obtain information on perceived causes of malaria, health seeking behaviour, use of mosquito control products, consumption expenditure, income, possession of assets and demographic characteristics of the sample population. The contingent valuation method was used to elicit households stated willingness to pay for ITNS. The survey data was complemented by focus group discussions. Expressed willingness to pay for ITNs was as high as 92% but current usage of untreated bed nets among respondents was only 17%. The main reasons cited for low usage of nets were lack of ready cash, cost of nets and non availability. Mean maximum willingness to pay was 9120.00 cedis (US$3.8) which is lower than the current factory price of 13200.00 cedis (US$5.5). Willingness to pay was strongly determined by household size, the type of payment mechanism available, the use of untreated nets and possession of radio. Households are also more concerned about acquiring nets for the whole family rather than for the protection of the child. The lack of ready cash coupled with the percentage of income that poor households will require to buy insecticide treated nets will be an obstacle to net use. Poor households will require about 4.5% of total annual expenditure to be able to acquire an average of three nets adequate for the family at the expressed mean willingness to pay. At the present factory price they will need 6.6% to be able to buy three nets on average for family use compared to 1.5% from higher income earners. Inability to purchase nets for cash was also shown by the number of households willing to pay on an instalment basis. About 56% of households were willing to pay on credit basis against 18% that wanted to pay cash. Maximum willingness to pay was also higher among households willing to pay on a credit basis than for households willing to pay cash. Research into the feasibility of different payment schemes in local communities is very critical if this tool for malaria control is to be expanded and sustained. The feasibility of different financing mechanisms would not only reduce the initial cost of buying insecticide treated nets to households but would also increase willingness to pay and make payments for re-impregnation much easier. Research into how to protect the very poor and vulnerable should also be a focus in the promotion and use of ITNs.

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