Background:
There is an urgent need for universal access to modern contraceptives in Nigeria, to facilitatethe achievement of the Millennium Development Goals and other national goals. This studyprovides information on the potential role of community solidarity in increasing access tocontraceptives for the most-poor people through exploration of the role of altruism by determining level of altruistic willingness to pay (WTP) for modern contraceptives acrossdifferent geographic contexts in Nigeria.
Methods:
It was a cross-sectional national survey which took place in six states spread across the sixgeopoliticalzones of the country. In each state, an urban and a rural area were selected for thestudy, giving a total of 6 urban and 6 rural sites. A pre-tested interviewer-administeredquestionnaire was used to collect information from at least 720 randomly selectedhouseholders from each state. The targeted respondent in a household was a female primarycare giver of child bearing age (usually the wives), or in her absence, another femalehousehold member of child bearing age. A scenario on altruistic WTP was presented beforethe value was elicited using a binary with open-ended follow-up question format. Test ofvalidity of elicited altruistic WTP was undertaken using Tobit regression.FindingsMore than 50 % of the respondents across all the states were willing to contribute somemoney so that the very poor would be provided with modern contraceptives. The averageamount of money that people were willing to contribute annually was 650 Naira (US$4.5).Mean altruistic WTP differed across SES quintiles and urban-rural divide (p < .01). Multipleregression analysis showed that age was negatively related to altruistic WTP (p < 0.05).However, years of schooling, being employed by government or being a big business person,prior experience of paying for contraceptives and socioeconomic status had statisticallysignificant effects on altruistic WTP (p < 0.05).
Conclusion:
There is room for community solidarity to ensure that the very poor benefit from moderncontraceptives and assure universal coverage with modern contraceptives. The factors thatdetermine altruistic WTP should be harnessed to ensure that altruistic contributions areactually made. The challenge will be how to collect and pool the altruistic contributions forpurchasing and delivering modern contraceptives to the most-poor, within the context ofcommunity financing.