Willingness-to-Accept and Willingness-to-Pay Ratios of Prevention of Mother-to-Child Transmission Services in a Nigerian Hospital: A Cross-Sectional Contingent Valuation Study

Abstract

Background: In Nigeria, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome treatment and care services, prevention of mother-to-child transmission (PMTCT) inclusive , are accessed free of charge by patients due to finanacial support from donor agencies. This trend may not be sustainable in the future due to the present global economic realities. Hence, there is the need to ascertain the readiness of PMTCT patients to pay for such services. Objectives: This contingent valuation study determined the willingness-to-accept (WTA), willingness-to-pay (WTP), and WTA-to-WTP ratios of PMTCT services among clients in a Nigerian tertiary hospital. Methods: This was a cross-sectional questionnaire-based study. All adult PMTCT patients who had never paid for any component of the services participated in the study. The questionnaire measured their WTP and WTA for the following components of PMTCT: primary prevention of HIV, prevention of unintended pregnancy in HIV-positive women, follow-up treatment and support, and therapeutic interventions around delivery. The WTP and WTA for PMTCT drugs and specialized clinical pharmacy services were also measured. The WTA-to-WTP ratios, income effects, and income elasticity were determined for all services. Questions were posed using Naira (N) ($1 ¼ N250, at the time of the study). Results: Respondents aged 25 to 34 years comprised 80.8% of the population, whereas 80.8% were married. The mean amounts of WTA and WTP for services involving primary prevention of HIV was N543 000 and N18 600, respectively. Its WTA-to-WTP ratio and approximate income effect were 29.19 and -28.19, respectively. These variables were associated with WTP for some services: level of education with PMTCT follow-up treatment and support (P¼.046), trimester of pregnancy with primary prevention of HIV (P¼.002), correspondent's residence with specialized clinical pharmacy services (P¼.003), and time spent to reach facility with primary prevention of HIV (P¼.002). Conclusions: All services had high WTP, WTA-to-WTP ratios, and income effects, with inelastic income elasticity coefficients: patients in the Nigerian hospital attribute high value to all PMTCT services.

How do patients prefer specialized clinical pharmacy service to other prevention of mother‐to‐child transmission of human immunodeficiency virus services? An evaluation of their willingness to pay and willingness to accept choices and ratios

“…The only published work on all aspects of PMTCT services that considered both WTP and WTA, to the best of the knowledge of the authors, was the pilot study of the present work which was conducted at Nigeria's Enugu State University Teaching Hospital. 24 Almost all the findings of that study were similar to the results of this present study. However, several works have been conducted on the WTP-of HIV-related services.…”

“…19,23 The WTA-WTP ratio gives more information than either WTA or WTP alone. 24 The objective of this study was to evaluate the WTP, WTA and WTA-WTP ratios for Specialized Clinical Pharmacy Service and PMTCT services among patients attending HIV/AIDs clinics of two tertiary hospitals in Nigeria.…”

The Maternal Referral Mobile Application System for Minimizing the Risk of Childbirth

“…This condition is also one of the problems in the referral process. 8 Being late in making decision of asking for medical care is one of the reasons of the referral process being blocked. 5 In our study among the causes of maternal death we found 3 delays (late decision making, late arrival at the health facility and delay in receiving medical assistance).…”

Estimating the Value of Statistical Life in a Road Safety Context Based on the Contingent Valuation Method

“…There are grey areas in the literature, and African countries are among them. Numerous VSL studies are conducted in Africa in contexts other than road safety, e.g., alcoholrelated harms in South Africa [36], malaria control in Zanzibar [37], prevention of mother-to-child transmission services in a Nigerian hospital [38], and water hyacinth control in Ethiopia [39]. In the literature that we examined since 2010, we found only one VSL study conducted in the road transport context in Sudan in 2015 [21] from African countries, according to the databases searched.…”