Can farmed fish match the preference of consumers accustomed to wild fish? Evidence from Central Malawi.

The existing capacity of capture fisheries in Malawi is operating at its maximum potential, unable to meet the growing demand for fish. To address this issue, expanding the output of the aquaculture sector appears to be the only viable solution for augmenting fish supply and consumption. However, consumers in Malawi prefer fish sourced from their natural habitats, often considering farmed fish as inferior. Fortunately, advancements in breeding techniques and aquaculture management have led to improved quality of farmed fish. In this study, our objective was to identify and compare the desired characteristics and marketing preferences of fresh tilapia among consumers in Malawi with those of aquaculture-produced fish. This comparison aimed to determine if farmed fish align with consumer expectations. A conjoint experiment was conducted in Lilongwe city targeting 280 fresh tilapia fish consumers. Preferences and associated willingness to pay were modeled using rank-ordered logit regression. The findings indicate that consumers favor smaller-sized fish (around 130 g), a size that is currently achievable through aquaculture practices. Interestingly, consumers displayed less enthusiasm for a pricing model based solely on weight. Notably, although consumers maintain a belief that wild-caught fish is superior to farmed fish, they indicated a willingness to pay for farmed products. The current technology and practices allow aquaculture farms to produce fish within the preferred size range, which presents an opportunity for sector expansion. However, achieving this potential requires effective marketing strategies to shift cultural perceptions that currently hinder the acceptance of farmed fish.

Consumer willingness to pay (WTP) for beef based on color and price discounts.

Discoloration of beef products leads retailers to offer discounts or discard beef products, as consumers tend to reject a brownish beef color. This practice contributes to retail food waste and inefficient resource allocation linked to beef production. The objective of this study was to investigate U.S. consumer preferences for beef color and price discounts. After an initial test for screen acuity regarding color perception using a condensed form the ishihara test, data on meat purchasing behavior as well as demographic information was collected for all participants. An additional part of the study undertook a hypothetical discrete choice experiment using digital photos of beef steaks with different meat color, price, and discount labels in retail packaging to examine consumer preferences, willingness to pay, and the effects of discount pricing. Results of a Mixed Logit Model based on choice data show that beef shoppers perceive, see, and prefer color nearly linearly across days of retail display. Consumers' willingness to pay was negative for 4, 7 and 9 days of retail display relative to day zero and decreased with an increase in discoloration. Results indicate that beef shoppers would have to be financially compensated for choosing a steak that was discolored after 9 days of retail display. However, male beef buyers exhibit weaker preferences for color and could be a target segment for promoting discolored beef products to reduce meat waste.

The effect of information about hazardous chemicals in consumer products on behaviour - A systematic review.

Exposure to hazardous chemicals in consumer products poses significant risks to personal health and the environment, and the combined effects may be negative even if each individual exposure is low. This necessitates informed and effective policies for risk reduction. This systematic review aims to identify and analyse existing evidence on how consumer preferences, product use, and product disposal are affected by information on harmful chemicals in consumer products and by price interventions. The review is conducted according to the PRISMA 2020 guidelines, synthesises forty-eight scientific articles on the relationship between information and consumer responses. No corresponding studies on the effects of price interventions were found. A large share of the identified articles focused on household chemicals, where warning labels are common, while less has been published on "everyday products" where the presence of hazardous chemicals is less clear to consumers. Effects of information on hazardous chemicals on consumer behaviour are highly contextual and dependent on the type of product, consumer behaviour and what kind of label is used. Warning symbols are effective in communicating a general warning of a potential danger, although consumers often misinterpret specifics regarding the exact nature of that danger or what means should be taken to minimise it. Informational texts are more informative but are also often missed or quickly forgotten. Consumer willingness to pay for safer products is generally positive but low. Additional research on how consumers react to information and price signals on chemical hazards is needed to improve policy design.

Re-domestication of feral pigs in Martinique: first results of growing-finishing trials to test meat consumption and consumers' perceptions.

In Martinique, pig production satisfies less than 20% of demand for pork, with traditional pig farming and wild pig hunting covering only a small proportion. This study has three parts: (i) for the first time, it analyses the performance of domesticated descendants of Creole feral pigs of Martinique based on a 29-day finishing test on two farms (A vs. B) with the same fibre-rich diet on a total of 40 pigs; (ii) it evaluates consumers' tastes based on a sensorial test by an untrained panel of 61 consumers who tasted pork prepared as a fricassee from either farm A or farm B; and (iii) evaluates willingness to pay (WTP) for Creole pork products and of the design of a future niche market. The average daily gain (ADG) of the finishing pigs was higher on farm A than on farm B (256 vs. 100 g/d, P < 0.001) resulting in a higher hot carcass weight on farm A than farm B (41.3 vs. 33.5 kg, P < 0.01), and better hot carcass yield on farm B than farm A (74.0 vs 68.8 %, P < 0.01). In the sensorial test, the consumers gave a higher score to the meat originating from the youngest pigs (Farm B), especially scores for tenderness and juiciness (+0.94 and +0.55 points, P < 0.05 and P=0.10, respectively). The 61 respondents were willing to pay more for processed products (sausage, pâté, ham) than for fresh meat. They considered that Creole pork has a better taste and is of better quality than industrial meats originating from mainstream genotypes. According to the majority of respondents, Creole pork should be rich in intra-muscular fat (100% of respondents) and low in inter-muscular fat (60% of respondents). Based on the survey, the main desirable future for Martinique's Creole pig production correspond to a low-carbon system with feed based on local resources, with on-farm slaughtering and short-distance sales (direct-to-consumer farm gate sale, sale at the butcher's or at the pig cooperative).

Exploring residents' willingness to pay for the research and development of renewable energy: A survey from first-tier cities in China.

The research and development (R&D) of renewable energy (RE) is crucial for cost reduction in electricity generation and enhancing power system stability. Compared to traditional fossil fuels, it demands more financial support. To investigate Chinese residents' willingness to pay (WTP) for the R&D of RE and its influencing factors, we conducted a large-scale online survey in four first-tier cities in China in 2023. The research findings indicate that (1) Chinese residents are willing to pay approximately 31.20 yuan (4.34 USD) per month for the R&D of RE. (2) WTP is higher under a mandatory payment model than a voluntary one. (3) Electricity consumption, environmental concern, environmental behavior, willingness to participate, satisfaction with government RE policies, and trust in the government's environmental governance capability significantly influence WTP. (4) Younger, male, and larger household residents exhibit higher WTP. Based on these findings, targeted policy recommendations were proposed.

Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey.

BACKGROUND: Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non-National Immunisation Program vaccines and are optional and generally fully self-paid by vaccinees. OBJECTIVE: To assess parents' demand for HPV vaccination by eliciting their willingness-to-pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. METHODS: A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12-16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness-to-pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness-to-pay. RESULTS: A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness-to-pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness-to-pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education-level was not significantly correlated with willingness-to-pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness-to-pay across different income-levels. CONCLUSIONS: There is a large gap between parents' willingness-to-pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high-risk population groups.

Willingness to pay for expanded non-invasive prenatal screening - An online discrete choice experiment from the perspective of women living in Western Australia.

INTRODUCTION: Ongoing advances in genetic technology may soon provide prenatal screening for multiple genetic conditions. AIMS: The aims were to investigate what prenatal screening test characteristics women prioritise and their willingness to pay for these tests. METHODS: We designed an online survey incorporating a series of discrete choice scenarios. Dimensions and levels were selected based on existing prenatal tests and a hypothetical prenatal test that could non-invasively detect multiple genetic disorders in pregnancy. Participants were recruited from social media platforms. Data were analysed using conditional logistic regression and latent class analysis (LCA). RESULTS: A total of 219 women completed the survey. Women with higher incomes and those with a tertiary education were willing to pay more than other groups. The maximum willingness to pay was AUD1870 (95% confidence interval: 1630, 2112) for a hypothetical non-invasive test to detect multiple genetic conditions in early pregnancy. An LCA demonstrated considerable heterogeneity in preferences, differing in both overall preference for testing and test characteristics considered most attractive. Among the participants, decision factors cited by 14.5% of participants were the risk of pregnancy loss, making them less likely to undergo testing; for 32.1% participants, accuracy was a major factor, and they were very likely to have testing; for 12.9%, test availability early in pregnancy was a decision factor. CONCLUSIONS: If a non-invasive test that could detect the greatest number of genetic disorders in pregnancy was available, the priorities were test accuracy, risk of pregnancy loss and a test available early in pregnancy.

Parental willingness to pay and preference for human papillomavirus vaccine for girls aged 9-14 in subsidy scenarios in Shanghai, China.

Multiple studies have documented low human papillomavirus (HPV) vaccine uptake among Chinese girls. It remains crucial to determine the parental willingness to pay (WTP) HPV vaccine for girls. We conducted a cross-sectional study recruiting 3904 parents with girls aged 9-14 in Shanghai, China, employing an online questionnaire with a convenience sampling strategy. Parental WTP, both range of payment and estimated point value, were determined for themselves (or wives) and daughters. HPV vaccine uptake was 22.44% in mothers and 3.21% in daughters. Respondents favored WTP ≤ 1000 CNY/138 USD for themselves (or wives), whereas showed increasing WTP along with valency of HPV vaccine for daughters (2-valent: 68.62% ≤1000 CNY/138 USD; 4-valent: 56.27% 1001-2000 CNY/138-277 USD; 9-valent: 65.37% ≥2001 CNY/277 USD). Overall, respondents showed higher WTP for daughters (median 2000 CNY/277 USD; IQR 1000-3600 CNY/138-498 USD) than for themselves (2000 CNY/277 USD; 1000-3500 CNY/138-483 USD) or wives (2000 CNY/277 USD; 800-3000 CNY/110-414 USD) (each p < .05). Furthermore, parental WTP was higher for international vaccine and 9-valent vaccine (each p < 0.05). Between two assumed government subsidy scenarios, parental preference for 9-valent vaccine remained consistently high for daughters (approximately 24% in each scenario), whereas preference for themselves (or wives) was sensitive to payment change between the subsidy scenarios. Using a discrete choice experiment, we found domestic vaccine was commonly preferred; however, certain sociodemographic groups preferred multivalent HPV vaccines. In conclusion, the valency of HPV vaccine may influence parental decision-making for daughters, in addition to vaccine price. Our findings would facilitate tailoring the HPV immunization program in China.

Willingness to pay for chronic disease management services provided by primary care nurses.

BACKGROUND: Due to the rapid increase in chronic diseases in South Korea, the Korean government has expanded chronic disease management to primary care. Thus, the role of primary care nurses is critical. However, the fee for chronic disease management services provided by primary care nurses has not been set, and few studies have evaluated the value of nursing services. This study aimed to estimate the willingness to pay (WTP) for chronic disease management services provided by primary care nurses and to identify the factors that affect WTP. METHODS: This study adopted a descriptive research design and conducted a cross-sectional online survey from January 16 to 18, 2023. The inclusion criteria were community residents aged ≥ 20 years living in South Korea and capable of participating in online surveys. A total of 520 people participated in this study. A contingent valuation method (CVM) was used with double-bound dichotomous choice questions along with open-ended questions. The mean WTP was calculated using a Tobit model. RESULTS: The mean WTP of the 520 study participants for one chronic disease management service provided by primary care nurses was 15,390.71 Korean won ($11.90). Factors affecting WTP were having a chronic disease, recognition of primary care nurses, and the first-bid price. Community residents with fewer chronic diseases, high awareness of primary care nurses, and a higher first-bid price showed higher WTP for chronic disease management services provided by primary care nurses. CONCLUSIONS: Primary care is important worldwide due to the increasing number of chronic diseases, and Korea is no exception. However, payment for services by primary care nurses is undervalued compared to their critical role and skills. This has led to problems such as a primary care nurse shortage and burnout. This study estimated individuals' WTP for chronic disease management services provided by primary care nurses. The results can be used as a basic resource for setting the fee for services provided by primary care nurses. It is also a good starting point to understand the benefits of primary care nurse services.

Assessing farmers' willingness to pay for FMD vaccines and factors influencing payment: a contingent valuation study in central Oromia, Ethiopia.

BACKGROUND: Foot and mouth disease is a contagious, transboundary, and economically devastating viral disease of cloven-hoofed animals. The disease can cause many consequences, including decreased productivity, limited market access, and elimination of flocks or herds. This study aimed to assess farmers' willingness to pay (WTP) for foot and mouth disease (FMD) vaccines and identify factors influencing their WTP. A cross-sectional questionnaire survey was conducted on 396 randomly selected livestock-owning farmers from three districts in the central Oromia region (Ambo, Dendi, and Holeta districts. The study utilized the contingent valuation method, specifically employing dichotomous choice bids with double bounds, to evaluate the willingness to pay (WTP) for the FMD vaccine. Mean WTP was assessed using interval regression, and influential factors were identified. RESULTS: The study revealed that the farmer's mean willingness to pay for a hypothetical foot and mouth disease vaccine was 37.5 Ethiopian Birr (ETB) [95% confidence interval [CI]: 34.5 40.58] in all data, while it was 23.84 (95% CI: 21.47-26.28) in the mixed farming system and 64.87 Ethiopian Birr (95% CI: 58.68 71.15) in the market-oriented farming system. We identified main livelihood, management system, sales income, breed, keeping animals for profit, and foot and mouth disease impact perception score as significant variables (p ≤ 0.05) determining the farmers' WTP for the FMD vaccine. CONCLUSION: Farmers demonstrated a high computed willingness to pay, which can be considered an advantage in the foot and mouth disease vaccination program in central Oromia. Therefore, it is necessary to ensure sufficient vaccine supply services to meet the high demand revealed.

Acceptability and willingness to pay for a hypothetical HIV vaccine in Brazil and the implications: a cross-sectional study.

INTRODUCTION: The Human Immunodeficiency Virus (HIV) is one of the greatest public health challenges still facing communities worldwide, and until this moment, no vaccine is available for its prevention. In Brazil, the Rio de Janeiro State has stood out regarding the prevalence of this disease. As a result, an important state to consider the Willingness to Pay (WTP) for a hypothetical HIV vaccine to help with future pricing. METHODS: A cross-sectional study was conducted to assess the acceptability and WTP of individuals from Rio de Janeiro State for a hypothetical HIV vaccine with a 70% efficacy. RESULTS: 600 individuals were interviewed and the acceptability for this hypothetical vaccine was 77.2%. In addition, 452 participants were eligible for the WTP analysis and would accept a WTP US$79.37 (400 BRL) for this vaccine, a higher value than that found in another study (200 BRL) conducted in the Northern region of Brazil under the same methodological conditions. CONCLUSION: Economic studies such as WTP can contribute to discussions regarding the prices and specifications for future vaccines, particularly for a HIV vaccine in countries such as Brazil with over 5,000 municipalities spread across regions with diverse characteristics and challenges in terms of socioeconomic, epidemiological and cultural differences.

Elicitation of societal preferences for chronic lymphocytic leukemia's treatments: a discrete choice experiment.

The overall value of treatments for chronic lymphocytic leukemia (CLL) depends on several factors, including preferences of the general population, who contributes to the financing of health systems. This study investigated societal preferences for attributes of CLL treatments in Italy. An online large-scale survey was designed using a discrete choice experiment (DCE) methodology and delivered to the Italian adult general population. Ten treatment attributes were identified, covering efficacy, safety, operational aspects and (hypothetical) out-of-pocket cost. DCE data were analyzed using a mixed logit regression model, estimating the willingness-to-pay for attribute levels' change. The general population significantly preferred more effective treatments, with shorter duration, administered orally rather than orally + intravenously. Changes in therapy duration, frequency of checkups and organ damage risk had the greatest impact on preferences. The integration of societal preferences in the value judgments of CLL therapies may help health authorities in establishing priority setting and taking pricing-reimbursement decisions.

Key Issues of Economic Evaluations for Health Technology Assessment in China: A Nationwide Expert Survey.

OBJECTIVES: Health technology assessment (HTA) is increasingly crucial in medicine price negotiations in China, yet prior appraisals revealed national discrepancies on key economic evaluation issues: willingness-to-pay (WTP) threshold, pricing models for multi-indication medicines, and comparator selection principles. This study aims to collect expert opinions on these issues for future HTA evaluations. METHODS: A nationwide anonymous web-based survey encompassing experts across academia, HTA, consultancy/contract research organization (CRO)/industry, service provider and payer. In 2023, a generic invitation containing a web link to the questionnaire was disseminated via WeChat using convenience and snowball sampling. Agreement rates for questionnaire views were analyzed using descriptive statistics. The relationship between participants' responses and demographics was examined using appropriate logistic models. RESULTS: 303 responses were received from experts in 34 cities. Key expert views include: a suggested base WTP threshold ranging from 0.5 to 1.5 times GDP (52.1% agreement); elevated thresholds for childhood diseases, rare diseases, end-of-life diseases, and first-in-class medicines (FICs) (>78.0% agreement); a single pricing model for multi-indication medicines (60.4% agreement); consideration of multiple medicines as comparators (79.9% agreement); and avoiding the use of centrally procured medicines as comparators for medicines with a time-to-market under three years (71.0% agreement). Participants who are service provider had lower odds of selecting higher thresholds (OR: 0.26; P<0.01) compared with responders from consultancy/CRO/industry. CONCLUSIONS: Expert views indicate the need for substantial changes in China's current HTA methods, highlighting the need for increased investment in HTA processes and expertise cultivation.

Does Willingness to Pay differ for mental and physical health?

OBJECTIVES: The urban environment can have a significant impact on mental and physical health. Health impact appraisal of new developments should address these issues. However, transferable economic valuation evidence for urban planners in the UK is thin, especially around mental health, making it harder to estimate the cost-efficiency of public health interventions to address these conditions. A further complication is that mental health may be perceived differently from physical health. This study examines Willingness to Pay (WTP) to avoid depression and lower back pain. METHODS: WTP estimates were obtained by applying contingent valuation tasks in an online survey with a representative sample in the UK (n=1553). Interval regression models were used to estimate the effects of disease severity, payment frequency, and respondent characteristics on WTP. RESULTS: Respondents' WTP to avoid both conditions was relatively high (around 5-6% of stated income to return to current health state). Depression was rated as being twice as burdensome on quality of life than Pain, and bids to avoid Depression were 20-30% more than Pain. Analysis of motivation responses suggests mental health treatment is perceived as less easy to access and less effective than the equivalent for pain, and respondents expect a larger burden on their family and relationships as they try to manage their condition themselves. CONCLUSIONS: Results suggest that depression bids may be affected by uncertainty around access to effective treatment in the health care system. This has implications for how mental illness may be prioritised in resource allocation towards public health interventions.

Valuation and perception of the costs of climate change on health.

BACKGROUND AND AIMS: Climate change affects our societies and lives through our economies, our livelihoods, and our health. Economic losses of climate change are estimated at $23 trillion, largely through externalities due to premature mortality, healthcare expenditure, and health-related work losses. Even if there are established methods to quantify the health economic burden, there is limited information on how people perceive this information. The current study aimed to examine different health cost evaluation methods and observe perceptions of stakeholders in the climate change context. METHOD: The participatory research approach of the World Café with 41 participants was applied to explore four topics associated with valuing the costs of climate change. The data were analyzed following an inductive approach. RESULTS: Despite the willingness-to-pay approach being widely applied, many experts see actual healthcare costs as a more explicit indicator of costs; however, this approach might underestimate actual costs. Participants experienced difficulties accepting and understanding cost estimates that indicated very high externalities as a percentage of gross domestic product. The cost-effectiveness of mitigation and adaptation measures was also challenged by a concern that while the costs of such measures are incurred now, the benefits do not come to fruition until later, for example, when building bike lanes or dams. CONCLUSIONS: Policies should favor environmentally friendly activities such as making cycling more convenient in cities with the health benefits presented in monetary terms, while limiting car driving. Moreover, the public might better understand the costs of climate change via tools that map how solutions influence different sectors and outlining the costs in evaluating the benefits for health and the environment.

How Sugar Labeling Affects Consumer Sugar Reduction: A Case of Sucrose Grade Labels in China.

The effectiveness of sugar labeling depends not only on direct sugar reduction but also on the extent to which compensatory eating occurs. This study focuses on the use of sucrose grade labels in the Chinese market to investigate not only consumers' willingness to pay (WTP) for different sucrose labels but also the consistency of their sugar control behavior when confronted with unlabeled processed foods. The findings reveal that consumers are willing to pay approximately 4%, 7%, and 7% more for yogurt labeled as "low sucrose", "no sucrose", and "no sucrose with sugar substitutes", respectively, compared to yogurt labeled as "regular sucrose." Furthermore, when subsequently presented with unlabeled toast, a significant proportion of consumers who initially chose "no sucrose" yogurt continued to select wholewheat toast, which contains less sugar than white and coconut toast. This indicates their commitment to maintaining their sugar control behavior. The study provides valuable experimental evidence for researchers, food manufacturers, and policymakers regarding the efficacy of sucrose grade labels. In particular, it offers policymakers insights into guiding consumers to promote sustainable healthy diets.

Economic valuation of Harmful Algal Blooms (HAB): Methodological challenges, policy implications, and an empirical application.

This paper presents a literature review on the economic valuation of Harmful Algal Bloom (HAB) impacts, identifying methodological challenges, policy implications, and gaps. Unlike previous literature reviews, we are particularly interested in determining whether the economic valuations of HABs have included a policy analysis. Our paper provides a conceptual framework that allows us to evaluate whether applications of economic studies of HABs are consistent with a well-defined economic welfare analysis. It links methodologies and techniques with welfare measures, data types, and econometric methods. Based on this literature review, we present an example of economic valuation that closes the gap between policy analysis and valuation methodology. We use a stated preferences study to estimate a "seafood price premium" to create a fund to support monitoring systems and for damage compensation to producers in the presence of HABs. Results show that most economic studies on HAB valuation do not consider any cost-benefit analysis of a defined policy intervention. The predominant economic valuation methodology uses market information to estimate a proxy for welfare measure of the impact of HABs (loss revenue, sales, exports). Moreover, nonuse and indirect use values are ignored in the literature, while stated preference methodologies are underrepresented. Finally, results from 1293 surveys found that people are willing to pay an increase in the price of mussels to support a policy that informs on HAB. However, the lack of institutional trust affects the probability of paying negatively.

Is wine perception influenced by sustainability information? Insights from a consumer experiment with fungus resistant grape and organic wines.

Literature has highlighted that the organic attribute has heuristic value for many consumers, representing an overarching signifier of positive characteristics. Nowadays a plethora of alternative systemic approaches side organic production in the aim to improve the overall sustainability of the agrifood sector. Current study, based on blind and informed tasting, measured sustainability information influence on respondents' (n = 162) perceptions of organic and fungus-resistant grape (FRG) white wines. Findings of the within-subject non hypothetical experiment revealed that information has a stronger, positive impact on participants' perception of organic wine (increasing 13 % monetary preferences) compared to FRG wine (+9%). Additionally, attitudinal characteristics driving consumers' preferences towards FRG wine diverge from organic core motivations.

Willingness to Pay for Social Health Insurance Among Public Health Workers in Gedeo Zone, Southern Ethiopia.

In Ethiopia, Social Health Insurance (SHI) implementation was delayed repeatedly due to employees' unwillingness to pay 3% of their monthly salary and fear related to the scheme's healthcare coverage. However, provisions of comprehensive training for health workers on health insurance and inclusion of healthcare financing methods in health practitioner education curriculum make their level of willingness to pay for SHI schemes uncertain. Thus, this study aimed to assess willingness to pay for the SHI scheme and its determinant factors among Healthcare providers in the Gedeo zone. From July 1 to 15, 2022, we carried out an institution-based cross-sectional study among 430 healthcare providers recruited using a multistage sampling technique. A multivariable logistic regression model was used to determine the factors associated with willingness to pay for Social Health insurance. Adjusted odds ratio (AOR) and P values of <.05 with 95% confidence intervals (CIs) were used to declare statistical significance. Out of 73.4% (95% CI: 68.8%, 77.6%) healthcare providers willing to join the SHI program, only 47.3% (95% CI: 41.5%, 53.2%) were willing to pay for the proposed 3% premium of their monthly salary. Healthcare providers who had >10, 000 Birr monthly salary (AOR = 2.45, 95% CI: 1.14, 5.26), difficulty in paying for healthcare (AOR = 3.55, 95% CI: 1.22, 10.29), history of chronic conditions (AOR = 4.61, 95% CI: 2.41, 8.82), positive attitude (AOR = 3.16, 95% CI: 1.62, 6.18), and good knowledge of the social health insurance scheme (AOR = 2.35, 95% CI: 1.17, 4.72) were more likely to pay for the social health insurance. More than half of the healthcare providers expressed a lack of willingness to pay for the social health insurance scheme. So, the government should provide an awareness creation program on the concepts and principles of the SHI scheme to improve the willingness to pay for the scheme.