Assessing the acceptability and willingness to pay for HIV services among patients at LVCT health HIV clinics
Otiso, Lilian Dr.
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There have been several calls for sustainability of the predominantly donor funded HIV programs globally due to reduction in HIV funding. User fees for HIV services were eliminated by the World Health Organization in 2006. This study sought to explore if it is acceptable (does not violate rights) to charge for HIV services and willingness to pay (WTP) for HIV care and treatment services among patients at LVCT Health clinics in Nairobi and Kisumu. It also sought to examine the factors that influence WTP health care payment methods for HIV services that patients in the clinics could use to pay for services. The study applied a cross-sectional survey design utilising quantitative data with some open ended questions. Three hundred and sixty (360) patients in LVCT Health clinics in Nairobi and Kisumu were issued with questionnaires and 337 responded. Quantitative data analysis techniques involving descriptive statistics, Chi square tests and logistic regression were carried out. Qualitative data was coded and presented in themes. Ethical approval was obtained from the Strathmore University Institutional Review Board. Findings revealed that only 16% of respondents found it acceptable to be charged for the services. Reasons given for not being acceptable were that patients are poor and would not afford treatment. 64.5% were willing to pay if donors withdrew funding support to the clinic, but majority (74.5%) were willing to pay less than Ksh 2000 per visit (estimated required amount Ksh 5000). There was significant association (p<0.05) between WTP and education level, income, presence of private medical insurance and having paid for HIV services before. 59.6% of respondents were enrolled in the National Hospital Insurance Fund (NHIF) and 61% were willing to use it to finance their treatment. Those who did not want to use it did not want their employer or insurance company to find out their HIV status. The findings demonstrate that though willing to pay, majority of HIV patients are poor and would not be able to afford user fees for HIV treatment making them vulnerable to its effects. NHIF and private medical insurance seem like viable options that should be explored to finance HIV treatment.