Patients’ willingness to pay for the treatment of TB in Nigeria: exploring own use and altruism
Abstract
Background
Although, current
treatment services for Tuberculosis (TB) in Nigeria are provided
free of charge in public facilities, the benefits (value) that
patients attach to such service is not known. In addition, the
prices that could be charged for treatment in case government
and its partners withdraw from the provision of free services or
inclusion of the services in health insurance plans are not
known. Hence, there is a need to elicit the maximum amounts that
patients are willing to pay for TB treatment services, both for
themselves and for the very poor patients that may not be able
to pay if some user fees are introduced (altruistic willingness
to pay).
Methods
A pretested
interviewer-administered questionnaire was used to elicit the
maximum willingness to pay (WTP) for TB treatment services from
TB patients in a tertiary hospital in southeast Nigeria. WTP was
elicited using the bidding game question format after a scenario
was presented to the respondents. Data was analysed using
tabulations. Tobit regression models were used to examine the
validity of the elicited WTP for own use and altruistic WTP.
Results
The results show that those
aged 30 years and below constituted more than two-fifth (43.2%)
of the respondents. More than half of the respondents (52.8%)
were not employed. 100 (80.0%) of the respondents were willing
to pay for their own use of TB treatment services while 78
(62.4%) of the respondents were willing to make altruistic
contributions so that the very poor could benefit from the TB
services. A Tobit regression analysis of maximum WTP for TB for
own use shows that respondents were willing to pay maximum
amounts at different statistically significant levels. The
results equally show that altruistic WTP was positively and
statistically significantly related to the employment status,
distance from UNTH and global seriousness of TB.
Conclusions
Most patients positively
valued the provision of free TB services and were willing to pay
for TB treatment for own use. The better-off ones were also
willing to make altruistic contributions. Free provision of TB
treatment services is potentially worthwhile, but there is
potential scope for continuation of universal provision of TB
treatment services, even if the government and donors scale down
their financing of the services.
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