BACKGROUND Expanding access to long-lasting insecticidal nets (LLINs) is difficult if one is limited to government and donor financial resources. Private commercial markets could play a larger role in the continuous distribution of LLINs by offering differentiated LLINs to middle-class Ghanaians. This population segment has disposable income and may be willing to pay for LLINs that meet their preferences. Measuring the willingness-to-pay (WTP) for LLINs with specialty features that appeal to middle-class Ghanaians could help malaria control programmes understand what is the potential for private markets to work alongside fully subsidized LLIN distribution channels to assist in spreading this commodity. METHODS This study conducted a discrete choice experiment (DCE) including a real payment choice among a representative sample of 628 middle-income households living in Ashanti, Greater Accra, and Western regions in Ghana. The DCE presented 18 paired combinations of LLIN features and various prices. Respondents indicated which LLIN of each pair they preferred and whether they would purchase it. To validate stated willingness-to-pay, each participant was given a cash payment of $14.30 (GHS 65) that they could either keep or immediately spend on one of the LLIN products. RESULTS The households' average probability of purchasing a LLIN with specialty features was 43.8% (S.D. 0.07) and WTP was $7.48 (GHS34.0). The preferred LLIN features were conical or rectangular one-point-hang shape, queen size, and zipper entry. The average WTP for a LLIN with all the preferred features was $18.48 (GHS 84). In a scenario with the private LLIN market, the public sector outlay could be reduced by 39% and private LLIN sales would generate $8.1 million ($311 per every 100 households) in revenue in the study area that would support jobs for Ghanaian retailers, distributors, and importers of LLINs. CONCLUSION Results support a scenario in which commercial markets for LLINs could play a significant role in improving access to LLINs for middle-income Ghanaians. Manufacturers interested could offer LLIN designs with features that are most highly valued among middle-income households in Ghana and maintain a retail price that could yield sufficient economic returns.

中文翻译：

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购买经杀虫剂处理的长效蚊帐的支付意愿：在加纳进行实际支付的离散选择实验。

背景技术如果仅限于政府和捐助者的财政资源，则难以扩展持久的杀虫网（LLIN）。通过向中产阶级加纳人提供差异化​​的LLIN，私人商业市场可以在LLIN的持续分销中发挥更大的作用。该人群具有可支配收入，并且可能愿意为满足其偏好的LLIN支付费用。测量具有加纳中产阶级吸引力的特殊功能的LLIN的支付意愿（WTP），可以帮助疟疾控制计划了解私人市场与完全受补贴的LLIN分销渠道一起工作以协助传播这种商品的潜力。方法该研究进行了一项离散选择实验（DCE），其中包括居住在加纳的Ashanti，大阿克拉和西部地区的628个中等收入家庭的代表样本中的实际支付选择。DCE展示了LLIN功能和各种价格的18种配对组合。受访者指出了他们更喜欢每对LLIN，以及是否愿意购买。为了验证声明的付款意愿，每位参与者将获得$ 14.30（GHS 65）的现金付款，他们可以保留或立即购买一种LLIN产品。结果家庭购买具有特殊功能的LLIN的平均概率为43.8％（SD 0.07），WTP为$ 7.48（GHS34.0）。LLIN的首选特征是圆锥形或矩形的单点悬挂形状，大号和拉链入口。具有所有首选功能的LLIN的平均WTP为$ 18.48（GHS 84）。在私有LLIN市场的情况下，公共部门的支出可以减少39％，私有LLIN的销售将在研究区域产生810万美元（每100户311美元）的收入，这将为加纳的零售商，分销商，以及LLIN的进口商。结论结果支持了以下场景：LLIN的商业市场可以在改善中等收入加纳人获得LLIN的机会方面发挥重要作用。感兴趣的制造商可以提供LLIN设计，使其具有加纳中等收入家庭中最受重视的功能，并保持零售价格可以产生足够的经济回报。公共部门的支出可以减少39％，私人LLIN销售将在研究区域产生810万美元（每100户311美元）的收入，这将为加纳的LLIN零售商，分销商和进口商提供工作。结论结果支持了以下场景：LLIN的商业市场可以在改善中等收入加纳人获得LLIN的机会方面发挥重要作用。感兴趣的制造商可以提供LLIN设计，使其具有加纳中等收入家庭中最受重视的功能，并保持零售价格可以产生足够的经济回报。公共部门的支出可以减少39％，私人LLIN销售将在研究区域产生810万美元（每100户311美元）的收入，这将为加纳的LLIN零售商，分销商和进口商提供工作。结论结果支持了以下场景：LLIN的商业市场可以在改善中等收入加纳人获得LLIN的机会方面发挥重要作用。感兴趣的制造商可以提供LLIN设计，使其具有加纳中等收入家庭中最受重视的功能，并保持零售价格可以产生足够的经济回报。结论结果支持了以下场景：LLIN的商业市场可以在改善中等收入加纳人获得LLIN的机会方面发挥重要作用。感兴趣的制造商可以提供LLIN设计，使其具有加纳中等收入家庭中最受重视的功能，并保持零售价格可以产生足够的经济回报。结论结果支持了以下场景：LLIN的商业市场可以在改善中等收入加纳人获得LLIN的机会方面发挥重要作用。感兴趣的制造商可以提供LLIN设计，使其具有加纳中等收入家庭中最受重视的功能，并保持零售价格可以产生足够的经济回报。