Abstract:
Background
Maternity waiting home is a residential facility located near qualified medical facilities
where pregnant woman can wait to give birth and provided a nutrition service.Lack of access
to obstetric services is one of the main causes of the high incidence of maternal and newborn
deaths. In Ethiopia, Most (86%) of the Maternity waiting homes had no budget allocated
from government funds and there is lack of revenue for the long term sustainability of the
nutrition services at Maternity waiting homes.Therefore, this study is important to sustain
the services provision to pregnan mothers at the maternity waiting homes.
Objective: The study aimed to identify an average annual maximum amount of households’
willingness to pay and its associated factors for the nutrition service provided to a pregnant
women staying at the Maternity waiting homes in East Wollega Zone of Oromia National
regional state, Ethiopia, September 2018.
Methodology: A community based cross sectional study design using double bounded
dichotomous choice contingent valuation method was used. The required sample size was
determined by using single population proportion. Data entry and analysis were made using
EpiData version 3.1 and SPSS for windows version 20 software respectively. Descriptive
statistics of frequency, binary and multiple logistic regression analysis were performed. The
association between explanatory variables and outcome variable were presented by an AOR
and confidence interval.
Results: A total of 845 respondents included in the study making a response rate of 98%.
Majority 80.8% of the respondents reported the seriousness of distance problem to the
pregnant women and all (100%) of the respondents reported the importance of the service.
About 94.3% of them were willing to pay above the currently paid price. The annual median
maximum amount of willingness to pay for the service was 15ETB (US$0.55) per year per
household.
The factors significantly associated with willingness to pay for the nutrition service, marital
status (being married: AOR=3.533, 95% CI=1.007-12.39), average monthly income (median
monthly income 1000ETB: AOR=3.287, 95%CI=1.194-9.049). More over, distance from the
health facility (at less than 5KM: AOR = 3.64, 95%CI = 1.256-10.55) and availability of
food (AOR=3.714, 95%CI=1.331-10.364), enough beddings (AOR=5.353, 95%CI=2.207-
13.010) and availability of cooking facilities (AOR=4.044, 95%CI=1.353-12.088) at a
maternity waiting homes were found to be predictors of maximum willingnessss to pay.
Conclusion and Recommendation: Maximum willingness to pay is mainly influenced by
factors such as: Marital status, monthly income, and distance, availability of food, beddings
and cooking facilities at maternity waiting homes. Majority of the respondents reported the
seriousness of distance problem and the importance of the service. Almost all of the
respondents were interested in and needed to support the services. The annual median
maximum amount of willingness to pay per year per household was higher than the currently
paid price. Therefore, there should be consideration in the availability of supplies and
equipments at maternity waiting homes and in amount of price to be paid per year per
household in order to strengthen the long-term financial sustainability of the service.