PDB81 Value of a Diabetes Prevention Program in Rural Kenya: Comparing Payment Card and Structured Haggling Willingness to Pay Methods

Abstract

Diabetes is a preventable disease with prevalence in Kenya considered on par with Western countries. Diabetes prevention and care is especially important in nonwestern countries because of the high costs and health burden associated with the acute care model of treatment, however it is unknown how rural residents will perceive such a program. Study objective was to value a diabetes prevention program (education, screening and referral) by comparing two willingness to pay (WTP) techniques in rural Kenya: the commonly used payment card (PC) and the recently developed structured haggling (SH), considered more consistent with Sub-Sahara African culture. Convenience sample of adult residents from a rural county in Kenya (Kiambu) were randomized to one of two WTP techniques, SH (Onwujekwe 2004) and PC. Program benefits (WTP data) were collected via individual face-to-face interviews. Ex-ante approach was used assuming: societal perspective, 5 year project life, and 3% discount rate. WTP data was collected from 158 rural residents (70% male, 2.5% diabetic, 11% own a vehicle and mean monthly expenditures of Ksh10,933 (US2011$ 127.12). Annual mean (SEM) WTP for the prevention program was Ksh628.75 [US2011$7.30] (70.98) for PC and Ksh 683.97 [US2011$7.95] (45.52) for SH per respondent per year, p=.516. Bids ranged from Ksh 0 to 5000. Assuming the program benefits 4800 rural adults, the program WTP is estimated at a mean of Ksh 14,420,838 (US2011$167,684). Diabetes prevention program have been shown to be effective in other countries. In the present study rural Kenyan residents did value a diabetes prevention program favorably. This is the first published study comparing PC and SH, however no statistical difference was perceived between the two WTP methods. As part of a larger study the benefits and costs will be compared to estimate the net societal benefit of the prevention program in rural Kenya.