Will women pay to prevent maternal death: An assessment of willingness to pay for misoprostol

BACKGROUND: Although misoprostol could greatly reduce maternal mortality from postpartum hemorrhage (PPH) in developing countries, little is known of women's willingness to pay (WTP) for misoprostol. OBJECTIVE: To assess women's WTP for misoprostol and identify factors associated with WTP using data from the 2007 evaluation of long-term use of misoprostol for household management of PPH in Kigoma, Tanzania. METHODS: Analysis of 939 women who delivered between August 2004 and May 2007. Women were asked if they would buy misoprostol and, if so, how much they would pay for it. Logistic regression examined factors associated with WTP and regression analyses identified factors that influenced the amount women would pay for misoprostol. RESULTS: 86% of women were willing to pay for misoprostol. Of those, 17% took misoprostol during the study period to treat PPH. Women who knew that PPH could cause death had almost twice the odds of WTP than women who did not, even after controlling for obstetric history and delivery characteristics. WTP for misoprostol is associated with multiple factors including individual knowledge, reproductive experience, and use of misoprostol. CONCLUSION: Most women in this study indicated they would purchase misoprostol, demonstrating that women welcome the ability to treat PPH at home deliveries. The positive effect of receiving information about PPH on WTP signifies the importance of education about PPH and misoprostol for future interventions. Understanding the factors associated with WTP for misoprostol has important implications for acceptability and sustainability of future programs.