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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 four-month 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. (excerpt)

Willingness-to-pay for services provided by the Clinical Services Improvement Project (CSI) in Egypt