title: Altruistic willingness to pay in community-based sales of insecticide-treated nets exists in Nigeria.
abstract: The objective of this study was to determine whether households who are willing to pay for insecticide-treated nets (ITNs) for themselves are prepared to contribute for the ITNs to be purchased for the indigent community members who cannot afford the nets. This was in the framework of community-based and directed sales for ITNs. The study was conducted in four malaria holoendemic communities in south-eastern Nigeria. Contingent valuation method was used to determine the altruistic willingness to pay (WTP) from randomly selected household heads or their representatives, which was elicited using an open-ended question. Theoretical validity was assessed using the Tobit model. Median altruistic WTP ranged from $0.11 to $0.21 across the four communities (95 Naira = $1). However, using a pooled data from the four communities, the mean was $0.34. In Tobit estimation, altruistic WTP varied significantly with two of the communities; the respondents were resident in, sex, marital status and the amount of savings of the respondent. It also varied significantly with the respondents' WTP for their own ITNs and average monthly household expenditures to treat malaria (p<0.05). Altruistic WTP will exist in community-based and directed sales of ITNs. Thus there can be intra-community subsidisation by the rich for the poor who may not be able to pay for the nets. Community mobilisation and sensitisation should be used to encourage able households to actually pay at least the amounts they have stated.
authors.affiliation: Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria. obinna.onwujekwe@lshtm.ac.uk
authors.forename: Obinna
authors.initials: O
authors.lastname: Onwujekwe
authors.forename: Reginald
authors.initials: R
authors.lastname: Chima
authors.forename: Elvis
authors.initials: E
authors.lastname: Shu
authors.forename: Douglas
authors.initials: D
authors.lastname: Nwagbo
authors.forename: Cyril
authors.initials: C
authors.lastname: Akpala
authors.forename: Paul
authors.initials: P
authors.lastname: Okonkwo
mesh_terms: D000328:Adult; D000533:Altruism; D001294:Attitude to Health / Q000208:ethnology*; D001512:Bedding and Linens / Q000191:economics*; D016009:Chi-Square Distribution; D005191:Family Characteristics / Q000208:ethnology; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D006801:Humans; D007306:Insecticides / Q000191:economics* / Q000627:therapeutic use; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000191:economics*; D009549:Nigeria; D012044:Regression Analysis; D015203:Reproducibility of Results; D012945:Social Values; D011795:Surveys and Questionnaires; D017664:Uncompensated Care
chemical_list: D007306:Insecticides