Community willingness to pay for maternal transport in Kabarole District, Western Uganda: A cross-sectional study

Abstract

Introduction: Saving Mothers Giving Life project in Kabarole district has supported maternal transportation to health facilities since 2012. There is need to sustain project outcomes when it winds up. We assessed community willingness to pay (WTP) for the maternal transport services and associated factors. Methods: We conducted a crosssectional study among household heads in Kabarole district. We used simple random sampling to select the villages and households and purposively selected household heads. We administered structured questionnaires to household heads. A household ead who reported that he/she was willing to contribute financially to the maternal transport services in the district was categorized as willing to pay. We obtained preferred entity to coordinate and manage the funds, preferred transport means, payment mode and amount of money through structured interviews. We used modified Poisson regression models to determine associations between WTP and the various characteristics of participants. Results: A total of 646 household heads were interviewed. The mean age was 33.8 years (SD±8.85). Most, 68% (442/646) were willing to pay for maternal transport. Of the 442 willing to pay, 65.38% preferred monthly payment with an average of UGX 2,207.6/= (<1.00 USD). Education was positively associated with WTP at all levels. Being married, participating in a saving scheme and staying more than five kilometers away from a heath facility were also associated with WTP: (APR 1.15, 95% CI 1.02-1.30), (APR 1.12, 95% CI 1.01-1.25), (APR 1.32, 95% CI 1.15-1.50) respectively. Conclusion: Households need to be mobilized, educated about the outcomes of accessing maternal services, and the need to pay for maternal transport. Payment modalities can be agreed upon by all stakeholders in a participatory and iterative process