title: Willingness to pay for maternal health outcomes: are women willing to pay more than men?
abstract: BACKGROUND
  Only a limited number of studies have specifically sought to analyse and try to understand sex differences in willingness to pay (WTP).
  
  
  OBJECTIVE
  To identify the role of sex in determining monetary values placed upon improvements in maternal health in Burkina Faso, West Africa.
  
  
  METHODS
  A contingent valuation survey using the bidding game method was conducted in the district of Nouna in 2005; a sample of 409 male heads of households and their spouses were asked their WTP for a reduction in the number of maternal deaths in the Nouna area. Ordinary least squares regression analysis was employed to examine the determinants of WTP.
  
  
  RESULTS
  Men were willing to pay significantly more than women (3127 vs 2273 West African francs), although this represented a significantly smaller proportion of their annual income (4% vs 11%). In the multivariate analyses of all respondents there was a significant positive relationship between WTP values and both starting bid and whether there had been a previous maternal complication in the respondent's household. However, there was a significant negative relationship between WTP and female sex. Once interactions between sex and income were taken into account, income did affect valuations, with a positive relationship between higher-income women and WTP values.
  
  
  CONCLUSIONS
  In absolute terms, men were willing to pay more than women, while women were willing to pay a greater proportion of their income. Differences between men and women in their WTP, both in absolute terms and in terms of proportion of income, can be explained by a household effect. Future studies should distinguish between individual income and command over decision making with respect to use of individual and household income, and gain further insight into the strategies used by respondents in answering bidding game questions.
authors.affiliation: Health Economics Research Unit, University of Aberdeen, Aberdeen, UK. l.ternent@abdn.ac.uk
authors.forename: Laura
authors.initials: L
authors.lastname: Ternent
authors.forename: Paul
authors.initials: P
authors.lastname: McNamee
authors.forename: David
authors.initials: D
authors.lastname: Newlands
authors.forename: Danielle
authors.initials: D
authors.lastname: Belemsaga
authors.forename: Adjima
authors.initials: A
authors.lastname: Gbangou
authors.forename: Suzanne
authors.initials: S
authors.lastname: Cross
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002050:Burkina Faso; D016009:Chi-Square Distribution; D004522:Educational Status; D005260:Female; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007182:Income; D008297:Male; D008427:Maternal Health Services / Q000191:economics* / Q000706:statistics & numerical data; D008428:Maternal Mortality; D008429:Maternal Welfare / Q000191:economics; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012737:Sex Factors