title: Factors influencing people's willingness-to-buy insecticide-treated bednets in Arbaminch Zuria District, southern Ethiopia.
abstract: Promoting self-financing healthcare helps restore efficiency and equity to national health systems. This study was conducted in malaria-endemic areas of southern Ethiopia to assess the bednet possession of the community, determine the people's willingness-to-pay for insecticide-treated bednets (ITNs), and identify what factors influence it. The study provided relevant information for programme planners and policymakers for evidence-based decision-making. This quantitative cross-sectional community-based study was conducted in four selected malarious Kebeles of Arbaminch Zuria district using a pretested interview-administered structured questionnaire. In total, 982 household heads were interviewed. The community's willingness-to-pay was assessed by contingent valuation, technique using binary with follow-up method. The advantage, the distribution, and the payment mechanism were explained, and three different qualities of ITN were shown by constructing a hypothetical market scenario. Of the 982 respondents, 466 (47.5%) households had at least one functional bednet. Of 849 children aged less than five years in the 982 households, 185 (21.8%) slept under a net the night preceding the survey. The results of the study revealed that around 86% of the respondents were willing to buy ITNs. The average maximum willingness-to-pay for three different types of bednets was statistically different. The maximum amount the people were willing to pay was US$ 3.3 for a blue conical ITN, US$ 3.2 for a white conical one, and US$ 1.7 for a blue rectangular ITN. The community's willingness-to-pay was significantly affected by gender, educational status, perceived benefit of ITN, previous source of bednet, and characteristics of bednet. The results showed that a significant proportion of the community people were willing to pay for ITNs. Therefore, introducing a subsidized ITN market rather than free distribution for all should be considered to ensure sustainability and self-reliance in the prevention and control of malaria.
authors.affiliation: CDC-Ethiopia, P.O. Box 11531, Addis Ababa, Ethiopia. freeshetu@yahoo.com
authors.forename: Frehywot Eshetu
authors.initials: FE
authors.lastname: Gebresilassie
authors.forename: Damen Haile
authors.initials: DH
authors.lastname: Mariam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D057148:Insecticide-Treated Bednets; D016015:Logistic Models; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000191:economics* / Q000379:methods*; D057147:Mosquito Nets / Q000191:economics* / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors; D055815:Young Adult