Assessment of determinants of willingness to pay for routine immunization among mothers of under five children residing in rural areas of Kano State
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Introduction: Routine immunization remains one of the most cost-effective public health interventions; however, sustainability challenges persist in low-resource settings due to funding constraints. This study assessed the determinants of willingness to pay (WTP) for routine immunization among mothers of under-five children in rural areas of Kano State, Nigeria.
Methods: A community-based cross-sectional study was conducted among 420 mothers selected through multistage sampling. Data were collected using a structured interviewer-administered questionnaire and analyzed using descriptive statistics, bivariate analysis and logistic regression. P-value of < 0.05 was considered significant.
Results: The proportion of mothers willing to pay for routine immunization services was 33.5%. The study participants were willing to pay an average of twenty thousand and twenty nine Naira forty Kobo with standard deviation of twelve thousand nine hundred and ninety seven Naira eighty Kobo. (N 20029.4 ± 14,519.7). Factors significantly associated with WTP included maternal age (OR=0.75) maternal education (OR = 3.44), household income (OR = 1.67), health care expenditure (OR=1.32), knowledge of immunization (OR = 2.72), and place of delivery (OR = 1.67).
Conclusion: The study concludes that socioeconomic factors, place of delivery and knowledge on benefits of routine immunization significantly influence WTP. Policies aimed at improving awareness and household economic empowerment may enhance financial sustainability of immunization programs.
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Adepoju, A. O., Preston, M. A., & Gonzales, G. (2020). Health literacy and health outcomes among Nigerian women. BMC Public Health, 20(1), 1–10. https://doi.org/10.1186/s12889- 020-08545-y
Adedire, E. B., Ajayi, I., Fawole, O. I., Ajumobi, O., Kasasa, S., Wasswa, P., & Nguku, P. (2016). Immunisation coverage and its determinants among children aged 12-23 months in Atakumosa-west district, Osun State Nigeria: A cross-sectional study. BMC Public Health, 16(1), 1–8. https://doi.org/10.1186/s12889-016-3531-x
Babatunde, O. A., Oladipo, O. A., & Adebowale, A. S. (2021). Knowledge and uptake of routine immunization among mothers in rural Nigeria. African Journal of Primary Health Care & Family Medicine, 13(1), e1–e8.
Bill, T., Gates, M., & Foundation, M. G. (2001). Immunization Focus A vaccine for Africa. Focus, June, 1–10.
Center, I. V. A. (2012). Landscape Analysis of Routine Immunization in Nigeria : Identifying Barriers and Prioritizing Interventions. 1–28.
Deogaonkar, R., Hutubessy, R., Van Der Putten, I., Evers, S., & Jit, M. (2012). Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries. BMC Public Health, 12(1), 1. https://doi.org/10.1186/1471-2458-12-878
Dong, H., Kouyate, B., Cairns, J., & Sauerborn, R. (2004). Willingness-to-pay for community- based insurance in Burkina Faso. Health Economics, 13(9), 877–890. https://doi.org/10.1002/hec.892
Fagbamigbe, A. F., Adebowale, A. S., & Morakinyo, O. M. (2017). Survival analysis of time to uptake of immunization among children in Nigeria. BMC Public Health, 17(1), 1–10.
Gadhia, R., & Makinen, M. (2005). Best Practices in Financial Sustainability Plans for Immunization Programs.
Gidado, S., Nguku, P., Biya, O., Waziri, N. E. ndi., Mohammed, A., Nsubuga, P., Akpan, H., Oyemakinde, A., Nasidi, A., Suleman, I., Abanida, E., Musa, Y., & Sabitu, K. (2014). Determinants of routine immunization coverage in Bungudu, Zamfara State, Northern Nigeria, May 2010. The Pan African Medical Journal, 18(May 2010), 9. https://doi.org/10.11694/pamj.supp.2014.18.1.4149
Harris, J. B., Gacic-dobo, M., Eggers, R., Brown, D. W., & Sodha, S. V. (2017). Global routine vaccination coverage, 2016. Releve Epidemiologique Hebdomadaire, 92(46), 701–707. https://doi.org/10.15585/mmwr.mm6842a1
Ichoku, H. E., Fonta, W. M., & Onwujekwe, O. E. (2017). Incidence and intensity of catastrophic healthcare financing in Nigeria. Journal of Public Health, 25(3), 269–277.
Kaddar, M., Lydon, P., & Levine, R. (2004). Financial challenges of immunization: A look at GAVI. Bulletin of the World Health Organization, 82(9), 697–702. https://doi.org/10.1590/S0042-96862004000900012
Levine, O. S., Bloom, D. E., Cherian, T., De Quadros, C., Sow, S., Wecker, J., Duclos, P., & Greenwood, B. (2011). The future of immunisation policy, implementation, and financing. The Lancet, 378(9789), 439–448. https://doi.org/10.1016/S0140-6736(11)60406-6
Munk, C., Portnoy, A., Suharlim, C., Clarke-Deelder, E., Brenzel, L., Resch, S. C., & Menzies, N. A. (2019). Systematic review of the costs and effectiveness of interventions to increase infant vaccination coverage in low-and middle-income countries. BMC Health Services Research, 19(1), 1–10. https://doi.org/10.1186/s12913-019-4468-4
Musgrove, P. (1993). Investing in health: the 1993 World Development Report of the World Bank. Bulletin of the Pan American Health Organization, 27(3), 284–286.
National Population Commission (NPC) [Nigeria], & ICF. (2019). Nigeria Demographic Health Survey 2018. The DHS Program ICF Rockville, Maryland, USA.
Ojo, K., Yisa, I., & Soyibo, A. (2011). Cost of routine immunization in Nigeria. … for Health Economics and …, June. http://www.checod.org/wp-content/uploads/2013/11/Publication-0011.pdf
Onwujekwe, O., Hanson, K., & Uzochukwu, B. (2019). Examining inequities in willingness to pay for healthcare services in Nigeria. Health Policy and Planning, 34(2), 123–131. https://doi.org/10.1093/heapol/czz012
Ophori, E. A., Tula, M. Y., Azih, A. V., Okojie, R., & Ikpo, E. P. (2014). Current trends of immunization in Nigeria: Prospect and challenges. Tropical Medicine and Health, 42(2), 67–75. https://doi.org/10.2149/tmh.2013-13
Ossai EN, Fatiregun AA. Clients' Willingness to Pay for Immunization Services in the Urban and Rural Primary Health Centers of Enugu State, Nigeria. J Public Health Afr. 2015 Mar 31;6(1):480. doi: 10.4081/jphia.2015.480.
Rezaei, S., Woldemichael, A., Mirzaei, M., Mohammadi, S., & Karami Matin, B. (2020). Mothers’ willingness to accept and pay for vaccines to their children in western Iran: a contingent valuation study. BMC Pediatrics, 20(1), 307. https://doi.org/10.1186/s12887-020-02208-4
Stéphenne, J. (2011). Vaccines as a global imperative-a business perspective. Health Affairs, 30(6), 1042–1048. https://doi.org/10.1377/hlthaff.2011.0338
UNICEF. (2018). Immunization Financing in MENA Middle-Income Countries. United Nations Children’s Fund, 90. https://www.unicef.org/mena/sites/unicef.org.mena/files/2018-04/immunization financing Web_0.pdf
Uzochukwu, B. S. C., Onwujekwe, O. E., & Akpala, C. O. (2018). Community perceptions and demand for immunization services in Nigeria. International Journal of Health Planning and Management, 33(2), e620–e634.
Walraven, G. (1996). Willingness to pay for district hospital services in rural Tanzania. Health Policy and Planning, 11(4), 428–437. https://doi.org/10.1093/heapol/11.4.428
Wang, S. A., Hyde, T. B., Mounier-Jack, S., Brenzel, L., Favin, M., Gordon, W. S., Shearer, J. C., Mantel, C. F., Arora, N., & Durrheim, D. (2013). Wang, S. A. et al. (2013) ‘New vaccine introductions: Assessing the impact and the opportunities for immunization and health systems strengthening’, Vaccine. doi: 10.1016/j.vaccine.2012.10.116. Vaccine, 31(SUPPL2). http://www.who.int/immunization/documents
Wonodi, B. C., Stokes-prindle, C., Aina, M., Oni, G., Olukowi, T., Pate, M. A., Privor-dumm, L., Levine, O., Resources, H., Melorose, J., Perroy, R., & Careas, S. (2012). Landscape Analysis of Routine Immunization in Nigeria. Landscape, 30(6), 2008–2011. http://www.jhsph.edu/research/centers-and-institutes/ivac/projects/nigeria/IVAC-Landscape-Analysis-Routine-Immunization-Nigeria-WhitePaper.pdf