Abstract

The Malawi health sector faces numerous challenges in delivering quality health care, including chronic under-funding. In light of direct donor budgetary support freeze, sustainability of the universal access model has been questioned and introduction of user fees proposed to mitigate financing gaps. This study aimed at generating demand side evidence to contribute towards informing policy direction around consumer WTP, key determinants influencing WTP, and probability of excluding the poor at different price levels. The study targeted 360 consumers of public healthcare at Bwaila Hospital, Kawale Health Centre, and Area25 Health Centre in Lilongwe urban. The contingency valuation method was used to collect data, using the stated preference approach. STATA12 was used to analyze the data, using tobit regression and marginal effects at mean analyses. Findings indicate that 81% of respondents are willing to pay user fees. Respondent age, prior awareness about user fees, gross income, spouse gross income, household attainment of minimum wealth status, and expectations about future service quality improvement were found to influence WTP. In addition, respondents exhibited characteristics of urban poverty: low per capita income (US$0.25); low asset ownership (8%); and lack of alternative viable care options other than government facilities. Thus, despite a high reported consumer WTP at 81%, the researcher recommends that Government should not introduce mandatory user fees in the face of current high urban poverty to avoid worsening access and further impoverishing the urban poor.

More details

School	: School of Law, Economics and Government
Issued Date	: 2016

Download full document