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Assessing Willingness to Pay for Environmental Health Interventions

Assessing Willingness to Pay for Environmental Health Interventions

Attended a great lecture today by Isha Ray and Jack Colford as part of a new BERC IdeaWorks series. It was a discussion of “Water resources for sustainability and health”, focusing mainly on water quality issues in the developing world. A number of interesting studies were described (amazingly clearly, given the complexity of them on the ground) by Dr. Ray and Dr. Colford – both masterful professors. Dr. Colford’s undertaking a multi-country assessment of water, sanitation, and hygiene interventions (individually and combined) to see their effects on height, weight, diarrhea. The challenge of doing this kind of randomized trial is not to be underestimated; they plan a year of pilots before the full study begins. A heady undertaking.

Dr. Ray described a couple studies that try to understand how people use these services, how they pay for them, and how they weigh options for water and sanitation. The most striking example she gave is a study kicking off shortly in Tanzania. Her research team is assessing how willing people are to use and pay for six commercially available point-of-use water treatments (like chlorine, a safe-water bucket, a UV filter, a biosand filter, etc). Her approach is novel. As with all studies of this sort, intervention devices will be given to participants. At the end of the study, she’ll try one of the following two things: (1) randomly give participants an envelope with a cash amount her team will pay to buy back the point-of-use device or (2) plan the study so that at its conclusion all devices are returned to the researchers; participants are given the option to buy the device back, again at a randomized price. Its an elegant solution to figuring out how much a person would be willing to pay for a technology that is available on the local market.

Our work in the stove world needs to look towards these kinds of assessments to help us frame the issue of poor uptake and compliance of cookstove usage. Both of these types of environmental health interventions often run into the same issues – the technology is poorly designed for the target population, or the population doesn’t perceive a need for it. Trying out locally available technologies and helping NGOs and governments figure out which ones people are willing to pay for — which we hope is a proxy for willing to use — is one step in the right direction.

This discussion ignores the impact of the devices on the market — it assumes they work. That’s a second, additional wrinkle that plays into the technology adoption.

You don't get what you expect, you get what you inspect.