Background: The introduction of rapid diagnostic tests (RDTs) has improved the diagnosis and treatment of
malaria. However, any successful control of malaria will depend on socio-economic factors that influence its
management in the community. Willingness to pay (WTP) is important because consumer responses to prices will
influence utilization of services and revenues collected. Also the consumer’s attitude can influence monetary
valuation with respect to different conditions ex post and ex ante.
Methods: WTP for RDT for Malaria was assessed by the contingent valuation method using a bidding game
approach in rural and urban communities in southeast Nigeria. The ex post WTP was assessed at the health centers
on 618 patients immediately following diagnosis of malaria with RDT and the ex ante WTP was assessed by
household interviews on 1020 householders with a prior history of malaria.
Results: For the ex ante WTP, 51% of the respondents in urban and 24.7% in rural areas were willing to pay for
RDT. The mean WTP (235.49 naira) in urban is higher than WTP (182.05 Naira) in rural areas. For the ex post WTP,
89 and 90.7% of the respondents in urban and rural areas respectively were WTP. The mean WTP (372.30 naira) in
urban is also higher than (296.28 naira) in rural areas. For the ex post scenario, the lower two Social Economic
Status (SES) quartiles were more willing to pay and the mean WTP is higher than the higher two SES while in the
ex ante scenario, the higher two SES quartiles were more WTP and with a higher WTP than the lower two SES
quartile. Ex ante and ex post WTP were directly dependent on costs.
Conclusion: The ex post WTP is higher than the ex ante WTP and both are greater than the current cost of RDTs.
Urban dwellers were more willing to pay than the rural dwellers. The mean WTP should be considered when
designing suitable financial strategies for making RDTs available to communities.