A Comparison of Willingness to Pay to Prevent Child Maltreatment Deaths in Ecuador and the United States

Abstract

Estimating the benefits of preventing child maltreatment (CM) is essential for policy makers to determine whether there are significant returns on investment from interventions to prevent CM. The aim of this study was to estimate the benefits of preventing CM deaths in an Ecuadorian population, and to compare the results to a similar study in a US population. The study used the contingent valuation method to elicit respondents’ willingness to pay (WTP) for a 1 in 100,000 reduction in the risk of CM mortality. After adjusting for differences in purchasing power, the WTP to prevent the CM mortality risk reduction in the Ecuador population was $237 and the WTP for the same risk reduction in the US population was $175. In the pooled analysis, WTP for a reduction in CM mortality was significantly impacted by country (p = 0.03), history of CM (p = 0.007), payment mechanism (p < 0.001), confidence in response (p = 0.014), and appropriateness of the payment mechanism (p < 0.001). These findings suggest that estimating benefits from one culture may not be transferable to another, and that low- and middle-income countries, such as Ecuador, may be better served by developing their own benefits estimates for use in future benefit-cost analyses of interventions designed to prevent CM.

Co-financing for viral load monitoring during the course of antiretroviral therapy among patients with HIV/AIDS in Vietnam: A contingent valuation survey

“…The CV method assumes that the variable Y i represents the WTP for testing of person i with characteristics X i , following the model [ 32 ]: where ε i has a normal distribution with a mean of zero. Since we observe respondents’ WTP indirectly via their responses to the CV questions, we know the value of Y i to lies within the interval [ Y i1 ; Y i2 ].…”

“…The DBDC-OE approach enhances the accuracy of WTP estimates, relative to the DBDC approach alone. Previous literature has suggested that DBDC-OE has a lower magnitude of starting point bias and incentive incompatibility than DBDC alone [ 32 , 33 ].…”

Willingness to pay for an early warning system for infectious diseases

“…The four papers in the field of health that empirically valued interventions increasing health safety, all used a form of stated preference methodology. These papers aimed to estimate the value of reducing mortality risks [6], preventing child maltreatment deaths [7], reducing the risk of sexually transmitted diseases [8] and vaccinations in pandemic outbreaks [9]. The first three papers used willingness to pay (WTP) contingent valuation method, while the last paper used a discrete choice experiment to elicit valuations.…”

How to value safety in economic evaluations in health care? A review of applications in different sectors

“…Dichotomous choice questions can be broken down into single- or double-bounded questions, where a double-bounded question means that, after being given an initial ‘yes or no’ WTP price, as in a single-bounded question, the respondent is then given a second WTP option dependent on his first answer [32]. The most popular question format of the 22 papers is an open-ended question (48%) [11, 15, 16, 19, 27, 29, 30, 33, 47], followed by dichotomous choice [1, 15, 17, 26, 40, 47, 54, 55] (35%), and payment card [33–37]. Two of the papers use both open-ended questions and dichotomous choice [15, 47].…”