PRM5 A REVIEW AND CLASSIFICATION OF CONTINGENT VALUATION METHOD STUDIES IN SUB-SAHARA AFRICA

Abstract

The primary objective is a review, classification and critical appraisal of contingent valuation method (CVM) healthcare studies conducted in Sub-Sahara Africa based on criteria by O'Brien and Gafni (1996). The secondary objective is to determine the impact of the Bamako Initiative adopted in the early 1990s on CVM studies in the same setting. CVM African healthcare studies (willingness to pay (WTP) and willingness to accept (WTA)), were identified using a comprehensive literature search in EconoLit, Google Scholar, Medline, PubMed and Web of Science between 1981 to 2010. CVM studies evaluated included WTP and WTA studies reporting primary data were included for evaluation. Primary assessment of the studies was based on the conceptual framework for evaluation of contingent valuation of healthcare programs (5 Items)(O'Brien and Gafni 1996). Secondary assessment was based on the time horizon of publication: pre-, during- (1990s), or post- BI, and area of intervention. Twenty-four CVM studies were evaluated: all used WTP and compensating variation. Elicitation techniques were dominated by bidding game (42%), followed by dichotomous choice (33%), and then payment card and the open ended formats (12.5%). Majority of studies (83%) were published after 2000, the remainder were published in the 1990s. Interventions included insurance (25%), medication (38%), and health services (38%). Healthcare CVM studies in Sub-Sahara Africa are limited despite the introduction of Bamako Initiative. The predominance of the bidding game elicitation technique in evaluated studies may be a reflection of the actual African market conditions. There is continuing debate as to which is the most appropriate CVM for healthcare studies conducted in Africa This debate will continue until these methods are compared to actual markets. CVM studies may start to engage the political market as Africa moves towards universal health coverage.