Chiwaula Levison Stanely, Chirwa Gowokani Chijere, Cataldo Fabian, Kapito-Tembo Atupele, Hosseinipour Mina C, van Lettow Monique, Tweya Hannock, Kayoyo Virginia, Khangamwa-Kaunda Blessings, Kasende Florence, Trapence Clement, Gugsa Salem, Rosenberg Nora E, Eliya Michael, Phiri Sam
Department of Economics, University of Malawi, P.O. Box 280, Zomba, Malawi.
Dignitas International, Zomba, Malawi.
BMC Health Serv Res. 2016 Apr 19;16:136. doi: 10.1186/s12913-016-1381-y.
Informal care, the health care provided by the patient's social network is important in low income settings although its monetary value is rarely estimated. The lack of estimates of the value of informal care has led to its omission in economic evaluations but this can result in incorrect decisions about cost effectiveness of an intervention. We explore the use of contingent valuation methods of willingness to pay (WTP) and willingness to accept (WTA) to estimate the value of informal care provided to HIV infected women that are accessing antiretroviral therapy (ART) under the Option B+ approach to prevention of mother-to-child transmission (PMTCT) of HIV in Malawi.
We collected cross sectional data from 93 caregivers of women that received ART care from six health facilities in Malawi. Caregivers of women that reported for ART care on the survey day and consented to participate in the survey were included until the targeted sample size for the facility was reached. We estimated the value of informal care by using the willingness to accept (WTA) and willingness to pay (WTP) approaches. Medians were used to summarize the values and these were compared by the Wilcoxon signed-rank test.
The median WTA to provide informal care in a month was US$30 and the median WTP for informal care was US$13 and the two were statistically different (p < 0.000). Median WTP was higher in the urban areas than in the rural areas (US$21 vs. US$13, p < 0.001) and for caregivers from households from higher wealth quintile than in the lower quintile (US$15 vs. US$13, p < 0.0462).
Informal caregivers place substantial value on informal care giving. In low income settings where most caregivers are not formally employed, WTP and WTA approaches can be used to value informal care.
NCT02005835.
非正式护理，即由患者社交网络提供的医疗保健，在低收入环境中很重要，尽管其货币价值很少被估算。缺乏对非正式护理价值的估算导致其在经济评估中被遗漏，但这可能导致关于干预措施成本效益的错误决策。我们探讨使用意愿支付（WTP）和意愿接受（WTA）的条件估值方法，来估算在马拉维预防母婴传播艾滋病毒（PMTCT）的B+方案下，为接受抗逆转录病毒治疗（ART）的艾滋病毒感染妇女提供的非正式护理的价值。
我们从马拉维六个卫生设施中接受ART护理的妇女的93名护理人员那里收集了横断面数据。在调查当天前来报告接受ART护理并同意参与调查的妇女的护理人员被纳入，直到达到该设施的目标样本量。我们使用意愿接受（WTA）和意愿支付（WTP）方法估算非正式护理的价值。中位数用于汇总这些价值，并通过Wilcoxon符号秩检验进行比较。
每月提供非正式护理的意愿接受中位数为30美元，非正式护理的意愿支付中位数为13美元，两者在统计学上有差异（p < 0.000）。城市地区的意愿支付中位数高于农村地区（21美元对13美元，p < 0.001），来自较高财富五分位数家庭的护理人员的意愿支付中位数高于较低五分位数家庭的护理人员（15美元对13美元，p < 0.0462）。
非正式护理人员对非正式护理给予了很高的价值。在大多数护理人员没有正式工作的低收入环境中，意愿支付和意愿接受方法可用于评估非正式护理的价值。
NCT02005835。
