Willingness to pay for small‐quantity lipid‐based nutrient supplements for women and children: Evidence from Ghana and Malawi

Abstract

Small‐quantity lipid‐based nutrient supplements (SQ‐LNS) are designed to enrich maternal and child diets with the objective of preventing undernutrition during the first 1,000 days. Scaling up the delivery of supplements such as SQ‐LNS hinges on understanding private demand and creatively leveraging policy‐relevant factors that might influence demand. We used longitudinal stated willingness‐to‐pay (WTP) data from contingent valuation studies that were integrated into randomized controlled nutrition trials in Ghana and Malawi to estimate private valuation of SQ‐LNS during pregnancy, postpartum, and early childhood. We found that average stated WTP for a day's supply of SQ‐LNS was more than twice as high in Ghana than Malawi, indicating that demand for SQ‐LNS (and by extension, the options for effective delivery of SQ‐LNS) may be very context specific. We also examined factors associated with WTP, including intervention group, household socioeconomic status, birth outcomes, child growth, and maternal and child morbidity. In both sites, WTP was consistently negatively associated with household food insecurity, indicating that subsidization might be needed to permit food insecure households to acquire SQ‐LNS if it is made available for purchase. In Ghana, WTP was higher among heads of household than among mothers, which may be related to control over household resources. Personal experience using SQ‐LNS was not associated with WTP in either site.

Small-quantity lipid-based nutrient supplements for children age 6-24 months: a systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifiers

“…Another advantage of integration is building on existing contact points between community front-line workers and families with young children, thus potentially reducing implementation costs (67). The cost of SQ-LNS is estimated at $0.07-0.14 per child per day not including distribution costs, depending on scale and location of production (68, 69). Further research is needed on the costs of programs promoting responsive care and learning opportunities targeting young children in LMICs and integration of such programs with nutrition programs (70).…”

Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: an individual participant data meta-analysis of randomized controlled trials

“…Provision of animal-source foods such as eggs is a promising strategy, but the evidence is too limited to draw conclusions regarding an impact on growth (67), and cost issues need to be considered. The cost of SQ-LNS is estimated at $0.07-0.14 per day (not including distribution costs), depending on scale and location of production (68, 69). A full discussion of cost issues is beyond the scope of this paper, but information on costs and willingness-to-pay is available elsewhere (68–71).…”

Food supplements to reduce stunting in Pakistan: a process evaluation of community dynamics shaping uptake

“…The trials conducted in Ghana, Haiti, Peru, Bangladesh and Malawi show wide acceptability of food supplements [13-15, 25, 26]. However, evidence from Ghana and Malawi found low WTP for food supplements in households indicating continued subsidization in provision of food supplements [27]. The sharing of supplements with other household members has been reported in at least two other studies, and highlights cultural imperatives to feed all family members and motherly instinct to share food among all her children that can hinder deliberative targeting of food supplements [13,14].…”