The willingness to accept and to pay for non-communicable disease screenings in rural Bangladesh: A contingent valuation study

Abstract

Background Bangladesh is experiencing a rapid increase in non-communicable diseases (NCDs). Early screening is essential to enable timely treatment. In Bangladesh, access to screening services for NCDs is often limited. This study aimed to elicit the willingness to accept (WTA) and the willingness to pay (WTP) for four screening packages for NCDs and their association with the respondents’ sociodemographic characteristics among rural communities in Bangladesh. Methods A cross-sectional survey using contingent valuation was conducted in six villages of Faridpur district, Bangladesh. The WTP was elicited using a double-bounded dichotomous choice and bidding game approach, with initial bid amounts based on local market prices. Logistic regression was used to identify factors associated with WTA and WTP, and a two-part model was employed to estimate mean WTP and its determinants. We used a double-limit dichotomous choice model with the respondents who took part in the bidding exercise. Results We found that 83% of the 346 respondents were willing to accept at least one screening package and among these 44% would be willing to pay to accept all screenings. The willingness to accept and pay varied largely by the type of screening being offered, with much lower proportions for obesity than for hypertension and diabetes. The results suggested that individuals from households with a member with an NCD were more willing to accept and pay for screening compared to those from households without an NCD. Married individuals in the highest wealth and expenditure tertiles were also more willing to pay than not-married individuals from middle- and low-wealth and expenditure tertiles. Sex and occupation influenced the amount individuals were willing to pay. Conclusions Our results encourage the development of screening interventions for NCDs in rural populations. Further research is needed to assess their feasibility, effectiveness and equity in Bangladesh on a larger scale.