Husband’s willingness-to-pay for HIV and syphilis screening at antenatal care clinic under the Thai universal coverage scheme

Abstract Background Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, the implementation has not been evidence-based, strategic risk-based, nor economically evaluated whereas husbands who accompanied the pregnant women are likely to have a lower risk than those who did not come along. This study is aimed to determine the husband’s willingness-to-pay (WTP) for his HIV and syphilis screening tests and potential factors affecting STI screenings at the antenatal care (ANC) clinic of a tertiary hospital in Thailand. Methods A pilot open-ended interview was conducted among 50 participants to estimate the mean and standard deviation of WTP prices for HIV and syphilis screening tests. A questionnaire was developed to obtain demographics, STI knowledge and screening history, as well as two contingent valuation methods (bidding and payment scale), using the mean WTP prices identified from the pilot study as a starting WTP with ¼SD step-up/down. The survey of 200 randomly selected husbands of pregnant women was conducted at King Chulalongkorn Memorial Hospital from April to June 2018. Descriptive statistics and logistic regression were used for data analysis. Results During the study period, 597 pregnant women received their first ANC. Of 368 accompanying husbands, 200 were enrolled in the study. Their median age was 31 (IQR 27-36) years old and 67% had a first child. Eighty-eight percent of the participants were willing to test for the STIs. Based on the bidding method, WTP prices for HIV and syphilis screening tests were US$14.5 (IQR 12.4-14.5) and US$9.7 (IQR 10-12), respectively. The payment scale method suggested approximately three-quarters of the WTP prices from the bidding method. Conclusions The husbands who accompanied their pregnant wives to the ANC clinic showed positive behaviors according to the propitious selection theory. They tend to cooperate well with STI testing and are willing to pay at least two times the price of the STI screening tests. The financial support to promote STI screenings should be reconsidered to cover other groups with higher sexual behavior risks and less WTP.

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Husband’s Willingness-to-Pay for HIV and Syphilis Screening at Antenatal Care Clinic under the Thai Universal Coverage Scheme

10.21203/rs.2.10818/v2 ◽

2019 ◽

Author(s):

Orawan Anunsittichai ◽

Krit Pongpirul ◽

Thanyawee Puthanakit ◽

Koranit Roowicha ◽

Jirarat Kaewprasert ◽

...

Keyword(s):

Pilot Study ◽

Willingness To Pay ◽

Antenatal Care ◽

Pregnant Women ◽

Universal Coverage ◽

Tertiary Hospital ◽

Screening Tests ◽

Transmitted Infection ◽

Care Clinic ◽

Syphilis Screening

Abstract Background Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, the implementation has not been evidence-based, strategic risk-based, nor economically evaluated whereas husbands who accompanied the pregnant women are likely to have a lower risk than those who did not come along. This study is aimed to explore the husband’s willingness-to-pay (WTP) for his HIV and syphilis screenings at the antenatal care (ANC) clinic of a tertiary hospital in Thailand. Methods A survey of 200 randomly selected husbands of pregnant women was conducted at King Chulalongkorn Memorial Hospital from April to June 2018. A pilot study using an open-ended question was conducted to estimate the WTP for HIV and syphilis screening tests. Then, two contingent valuation methods (bidding and payment scale) were performed for the final WTP assessments, using the mean WTP identified from the pilot study as a starting WTP with 1⁄4 SD step-up/down. Results During the study period, 597 pregnant women received their first ANC. Of 368 accompanying husbands, 200 were enrolled in the study. Their median age was 31 (IQR 27-36) years old and 67% had a first child. Eighty-eight percent of the participants were willing to test for the STIs. Based on the bidding method, WTP for HIV and syphilis screening tests were US$14.5 (IQR 12.4-14.5) and US$9.7 (IQR 10-12), respectively. The payment scale method suggested approximately three-quarters of the price. Conclusions The husbands who accompanied their pregnant wives to the ANC clinic showed positive behaviors according to the propitious selection theory. They tend to cooperate well with STI testing and are willing to pay at least two times the price of the STI screening tests. The financial support to promote STI screenings should be reconsidered to cover other groups with higher sexual behavior risks and less WTP.

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Husband’s Willingness-to-Pay for HIV and Syphilis Screening at Antenatal Care Clinic under the Thai Universal Coverage Scheme

10.21203/rs.2.10818/v1 ◽

2019 ◽

Author(s):

Orawan Anunsittichai ◽

Krit Pongpirul ◽

Thanyawee Puthanakit ◽

Koranit Roowicha ◽

Jirarat Kaewprasert ◽

...

Keyword(s):

Pilot Study ◽

Willingness To Pay ◽

Antenatal Care ◽

Pregnant Women ◽

Universal Coverage ◽

Transmitted Infection ◽

Care Clinic ◽

Strategic Risk ◽

First Child ◽

The Mean

Abstract Background Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, there has been no evidence-based strategic risk-based implementation nor economic evaluation whereas husbands who accompanied the pregnant women are likely to have lower risk than those who did not come along. This study is aimed to explore husband’s willingness-to-pay (WTP) for his HIV and syphilis screenings at ANC. Methods A survey of 200 randomly selected husbands of pregnant women was conducted at King Chulalongkorn Memorial Hospital from April to June 2018. A pilot study using an open-ended question was conducted to estimate the mean and standard deviation of WTP for HIV and syphilis screenings. Then, two contingent valuation methods (bidding and payment scale) were performed for the final WTP assessments, using the mean WTP identified from the pilot study as a starting WTP with 1⁄4 SD step up/down. Multivariate linear regression was performed to explore potential determinants of the price that the husbands are willing to pay. Results During the study period, 597 pregnant women received their first ANC. Of 368 accompanying husbands, 200 were enrolled in the study. Their median age was 31 (IQR 27-36) years old and 67% had a first child. Eighty-eight percent of the participants were willing to test for STIs. Based on the bidding method, WTP for HIV and syphilis tests were US$14.5 (IQR 12.4-14.5) and US$9.7 (IQR 10-12), respectively. The payment scale method suggested approximately three-quarter of the price. Expecting the first child and higher education were associated with a higher price (P <0.01). Conclusions The husbands presented at antenatal care clinic are willing to pay at least two times the cost of the STI test. The financial support to promote STI screenings should be reconsidered to cover other groups with higher sexual behavior risks and less willingness-to- pay.

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Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

BMJ Global Health ◽

10.1136/bmjgh-2020-004117 ◽

2021 ◽

Vol 6 (2) ◽

pp. e004117

Author(s):

Aniqa Islam Marshall ◽

Kanang Kantamaturapoj ◽

Kamonwan Kiewnin ◽

Somtanuek Chotchoungchatchai ◽

Walaiporn Patcharanarumol ◽

...

Keyword(s):

Health Insurance ◽

Social Health Insurance ◽

Universal Coverage ◽

Civil Servant ◽

Social Health ◽

Health Coverage ◽

Medical Benefit ◽

The Social ◽

Universal Health ◽

Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

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Reliability and validity of an individually focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

Public Health Nutrition ◽

10.1017/s1368980014001669 ◽

2014 ◽

Vol 18 (16) ◽

pp. 2895-2905 ◽

Cited By ~ 19

Author(s):

Barnabas K Natamba ◽

Hillary Kilama ◽

Angela Arbach ◽

Jane Achan ◽

Jeffrey K Griffiths ◽

...

Keyword(s):

Antenatal Care ◽

Food Insecurity ◽

Pregnant Women ◽

Internal Displacement ◽

Northern Uganda ◽

Cognitive Interviews ◽

Hiv Status ◽

Cross Sectional Survey ◽

Care Clinic ◽

Food Insecurity Access

AbstractObjectiveTo determine the reliability, validity and correlates of measures of food insecurity (FI) obtained using an individually focused food insecurity access scale (IFIAS) among pregnant women of mixed HIV status in northern Uganda.DesignA mixed-methods study involving cognitive interviews nested within a cross-sectional survey.SettingThe antenatal care clinic of Gulu Regional Referral Hospital.SubjectsSurvey respondents included 403 pregnant women, recruited in a ratio of one HIV-infected to two HIV-uninfected respondents, twenty-six (nine of them HIV-infected) of whom were asked to participate in the cognitive interviews.ResultsOver 80 % of cognitive interview participants reported understanding the respective meanings of six of the nine items (i.e. items 4 to 9) on the IFIAS. Two main factors emerged from rotated exploratory factor analysis of the IFIAS: mild to moderate FI (IFIAS items 1–6) and severe FI (items 7–9). Together, they explained 90·4 % of the FI measure’s variance. The full IFIAS and the two subscales had moderate to high internal consistency (Cronbach’s α ranged from 0.75 to 0.87). Dose–response associations between IFIAS scores, and measures of socio-economic status and women’s diet quality, were observed. Multivariate linear regression revealed significant positive associations between IFIAS scores and HIV infection, maternal age, number of children and a history of internal displacement. IFIAS scores were negatively associated with women’s diet diversity score, asset index and being employed.ConclusionsThe IFIAS showed strong reliability, validity and contextual relevance among women attending antenatal care in northern Uganda.

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Willingness of antenatal care attendees towards voluntary HIV counseling and testing, Southern Ethiopia

International Journal of Pregnancy & Child Birth ◽

10.15406/ipcb.2020.06.00206 ◽

2020 ◽

Vol 6 (4) ◽

pp. 104-112

Author(s):

Sintayehu Assefa ◽

Dubale Dulla

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Information Dissemination ◽

Statistical Significance ◽

Southern Ethiopia ◽

Cross Sectional ◽

Care Clinic ◽

Hiv Counseling And Testing ◽

Hiv Counseling ◽

Counseling And Testing

Background: Voluntary counseling and testing (VCT) is an entry point for the prevention of HIV transmission from mother to child and accessing VCT benefit from PMTCT services. Even though, some pregnant women clearly know the benefits /advantages of PMTCT services, they are not willing to test and access the services. Hence, this study was aimed to assess the willingness of pregnant women attending antenatal care towards VCT/PMTCT at Adare general hospital in southern Ethiopia. Method: An institution-based cross-sectional study was conducted at Hawassa Adare hospital, southern Ethiopia from February to April/2018. A total of 338 randomly selected pregnant women who were attending antenatal care clinic were included. Data was collected using structured and pretested questionnaire; entered and analyzed using SPSS version 20 computer software. Important descriptive and logistic models were used for data analysis assuming statistical significance at p < 0.05. Result: A total of 338 mothers were interviewed with a response rate of 100%. The willingness towards voluntary HIV counseling and testing among study participants was 82.2%. Participants who attended primary and High school and above were 3.9 (AOR= 3.87, 95% CI- 1.705, 8.782) and 9.5 times (AOR 9.53 at 95% CI- 3.155, 28.76); those who had good knowledge about VCT/PMTCT were 3.47 times (AOR=3.47, 95% CI-1.721, 7.003); women who followed two to three ANC visit, were 5.1 times more likely have willingness towards VCT/PMTCT (AOR 5.11 at 95% CI -1.095, 23.81) more likely willing to be tested than their counterparts respectively. Conclusion: Willingness towards voluntary HIV counseling was encouraging however it needs advancement. Since boosted knowledge and awareness promote willingness to VCT/PMTCT uptakes, initiation of community-based information dissemination, increased quality of ANC service, and empowering women to be educated could be effective in order to promote high VCT and PMTCT program uptakes

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Pengaruh Pendapatan, Pengetahuan Dan Kerentanan Penyakit Terhadap Willingness To Pay (WTP) Premi Jaminan Kesehatan Pada Pekerja Sektor Informal

KESMAS UWIGAMA: Jurnal Kesehatan Masyarakat ◽

10.24903/kujkm.v7i1.1094 ◽

2021 ◽

Vol 7 (1) ◽

pp. 48-59

Author(s):

Anom Dwi Prakoso

Keyword(s):

Health Insurance ◽

Willingness To Pay ◽

Informal Sector ◽

Low Income ◽

Disease Susceptibility ◽

Universal Coverage ◽

Health Coverage ◽

Cross Sectional ◽

Susceptibility Data ◽

Central Java

Background: The Indonesian Government's target of Universal Coverage or 100% Health Insurance participation by 2019 failed to be achieved, even until the end of October 2020. The failure of universal coverage resulted in BPJS Health's finances getting worse after experiencing a deficit. Informal sector workers are the most dominant sector that has not participated in the Health Insurance scheme, totaling 30,487,891 workers. Low income, uncertainty each month, and the increase in contributions resulted in a decrease in Willingness to pay Health Insurance contributions. Research purposes: The purpose of this study is to analyze the effect of income, knowledge, and disease susceptibility to the willingness to pay (WTP) of health insurance contributions to informal sector workers. Method: This cross-sectional research was conducted in Kudus Regency, Central Java in January-February 2020. Sampling used purposive sampling with a total of 200 informal sector workers who had not yet participated in BPJS Kesehatan. The dependent variable is a willingness to pay. The independent variables are income, knowledge, and disease susceptibility. Data collection using a questionnaire and data analysis with logistic regression. Result: Willingness To Pay health insurance contributions for informal sector workers increased in income ≥Rp 2,218,451 (b = 2.02; 95% CI = 1.01-3.55; p = 0.044), high knowledge (b = 4.64; 95% CI = 2.36-8.31; p <0.001), high disease susceptibility (b = 3.01; 95% CI = 0.26-5.75; p = 0.031). Conclusion: Income, knowledge, and disease vulnerability have a significant effect on the willingness to pay for health insurance contributions for informal sector workers. Keywords: Universal Health Coverage; Willingness To Pay; Health Insurance; informal sector workers.

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