Willingness to Pay (WTP) surveys are increasingly being used in reproductive health
programs to predict the impact of price changes on revenues, utilization and client
profile. The Clinical Services Improvement (CSI) project wanted to use a WTP survey to
measure client reaction to price increases for selected services. CSI also was interested in
knowing whether the actual behavior of clients matched their predicted behavior in the
WTP survey. The FRONTIERS program worked with CSI and the Cairo Demographic
Center (CDC) to carry out a WTP survey in 6 CSI clinics. Following the survey, CSI
increased the price of DMPA injections and then tracked DMPA clients over a fourmonth
period to determine which clients returned for subsequent injections and which did
not.
Most clients said they would be willing to pay higher prices for CSI services, and WTP
did not vary much by client economic status. If CSI were to implement the lower of the
three price increases in the survey, total clinic revenues would increase, and a small
number of CSI clients would seek services elsewhere. Client intention to discontinue
family planning use because of higher prices was almost non-existent. Among DMPA
clients, the level of agreement between stated and actual WTP was moderate; when noneconomic
reasons for discontinuation were taken into account, however, agreement
between client stated and actual WTP was much higher, both for individual clients and in
the aggregate. WTP surveys have the potential to be useful tools for predicting client
response to price increases, but predictions for methods like DMPA must be adjusted to
account for non-economic reasons for discontinuation.