How much are Ecuadorians Willing to Pay to Reduce Maternal Mortality? Results from a Pilot Study on Contingent Valuation.

Maria Isabel Roldos, Mpa, Ma, Drph,Justin Ingels,Phaedra Corso

doi:10.21106/ijma.166

Maria Isabel Roldos, Mpa, Ma, Drph, Justin Ingels + Show 1 more

Open Access

https://doi.org/10.21106/ijma.166

Copy DOI

Abstract

Context:There is an established association between the provision of health care services and maternal mortality. In Ecuador, little is known if the societal value is greater than the resources expended in preventive medicine.Aims:The purpose of this research is to investigate Ecuadorians’ willingness to pay to prevent maternal death and disabilities due to complications of care during childbirth in the context of universal coverage.Methods and Materials:The study elicited a “contingent” market on morbidity and mortality outcomes, specific to Ecuador’s epidemiologic profiles between a hypothetical market that included a 50% reduction in the risk of maternal mortality from 100 to 50 per 100,000, and a market that included a 50% reduction in the risk of maternal morbidity from 4,000 to 2,000 per 100,000.Results:The average amount participants are willing to pay (WTP) to prevent maternal mortality in the context of universal coverage, was $176 a year (95% CI=$172, $179). The unadjusted mean WTP for a reduction in the maternal morbidity risk was $135 (95% CI=$132, $139). Translated into Value of statistical Life, participant´s from this study valued the prevention of one statistical maternal death at USD $352,000.Conclusion:Results suggest that the costs of maternal care do not outweigh the benefit of prevention, and that Ecuadorians are willing to pay a significant amount to reduce the risk of maternal mortality.Global Health Implications:Reduction of maternal mortality will remain an important global developmental goal in the upcoming years. Having a monetary approximation on the value of these losses may have important implications in the allotting financial and technical resources to reduce it.

Highlights

Reducing population-level rates of maternal morbidity and mortality is an important developmental goal for many countries of the world
The average amount participants are willing to pay (WTP) to prevent maternal mortality in the context of universal coverage, was $176 a year.The unadjusted mean WTP for a reduction in the maternal morbidity risk was $135.Translated into Value of statistical Life, participants from this study valued the prevention of one statistical maternal death at USD $352,000
The study’s goal was to reach a sample of 400 people, of which 99% agreed to participate. Those that declined to participate did so because of lack of time and uninterested to participate.The final study sample consisted of a total of n=398 people, n=223 who were asked to respond to a risk reduction in maternal mortality risk, and n=175 who were asked to respond to a risk reduction in maternal morbidity risk

Summary

Introduction

Reducing population-level rates of maternal morbidity and mortality is an important developmental goal for many countries of the world. Maternal health is delivered at the first level of care.According to the World Health Organization’s (WHO) “3 delays” model, maternal mortality can be attributable to inadequate health care provision.[5,6] In brief, the 3 delays framework provides an understanding of the factors that result in obstetric emergencies into the following delays: i) the women’s and family’s decision to seek health care; ii) issues related to accessing medical facilities such as transportation barriers, roads or others; and iii) the receipt of inadequate and appropriate care.[7]

Results

Discussion

Conclusion