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Ability and willingness to pay for family planning services in low resource settings: evidence from an operational research


Nazarius Mbona Tumwesigye
Fredrick Makumbi
Aggrey Mukose
Lynn Atuyambe
Cissie Namanda
Sarah Ssali
Ritah Tweheyo
Andrew Gidudu
Carole Sekimpi
Catherine Verde Hashim
Martha Nicholson
Ritah Nakigudde Waddimba
Peter Ddungu

Abstract

Objective: This paper establishes levels and patterns of ability and willingness to pay (AWTP) for contraceptives, and associated factors.


Study design: A three-stage cluster and stratified sampling was applied in selection of enumeration areas, households and individuals in a baseline survey for a 5-year Family planning programme. Multivariable linear and modified Poisson regressions are used to establish factors associated with AWTP.


Results: Ability to pay was higher among men (84%) than women (52%). A high proportion of women (96%) and men (82%) were able to pay at least Ug Shs 1000 ($0.27) for FP services while 93% of women and 83% of men who had never used FP services will in future be able to pay for FP services costed at least Shs 2000 ($0.55). The factors independently associated with AWTP were lower age group (<25 years), residence in urban areas, attainment of higher education level, and higher wealth quintiles.


Conclusion: AWTP for FP services varied by different measures. Setting the cost of FP services at Shs 1000 ($0.27) will attract almost all women (96%) and most of men (82%). Key determinants of low AWTP include residence in poor regions, being from rural areas and lack of/low education.


Implications statement: Private providers should institute price discrimination for FP services by region, gender and socio-economic levels. More economic empowerment for disadvantaged populations is needed if the country is to realise higher contraceptive uptake. More support for total market approach for FP services needed.


Keywords: Ability-to-pay; willingness-to-pay; total market approach; market segmentation; family planning.


Journal Identifiers


eISSN: 1729-0503
print ISSN: 1680-6905