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Does improved risk information increase the value of cholera prevention? An analysis of stated vaccine demand in slum areas of urban Bangladesh

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  • Aziz, Sonia
  • Pakhtigian, Emily L.
  • Akanda, Ali S.
  • Jutla, Antarpreet
  • Huq, Anwar
  • Alam, Munirul
  • Ashan, Gias U.
  • Colwell, Rita R.

Abstract

As the world's longest running pandemic, cholera poses a substantial public health burden in Bangladesh, where human vulnerability intersects with climatic variability. Barriers to safe water and sanitation place the health of millions of Bangladeshis in jeopardy – especially those who have highly constrained choices in preventing and responding to cholera. In this paper we investigate demand for cholera prevention among residents in the Mirpur and Karail slum areas of urban Dhaka. Using survey data from 2023 households in two slum areas, we analyze responses from a contingent valuation questionnaire that elicited willingness to pay (WTP) for cholera vaccines across household members and under varying disease risk scenarios, finding higher valuation for cholera prevention for children and under scenarios of greater epidemic risk. We estimate the average WTP for a cholera vaccine for a child ranges from TK 134–167 (US$ 1.58–1.96). Consistently, respondents with prior knowledge of the cholera vaccine reported lower WTP valuations, providing suggestive evidence of concerns about vaccine effectiveness and preferences for cholera treatment over prevention. We supplement the contingent valuation analysis with cost of illness estimates from both our household sample as well as from administrative hospital records of over 34,000 cholera patients. We estimate that a household incurs costs of TK 801–922 (US$ 9.43–10.50) per episode of cholera that requires medical treatment. Taken together, these findings indicate higher WTP for cholera treatment compared to prevention, but increased interest in prevention under early warning system scenarios of high disease risk.

Suggested Citation

  • Aziz, Sonia & Pakhtigian, Emily L. & Akanda, Ali S. & Jutla, Antarpreet & Huq, Anwar & Alam, Munirul & Ashan, Gias U. & Colwell, Rita R., 2021. "Does improved risk information increase the value of cholera prevention? An analysis of stated vaccine demand in slum areas of urban Bangladesh," Social Science & Medicine, Elsevier, vol. 272(C).
  • Handle: RePEc:eee:socmed:v:272:y:2021:i:c:s0277953621000484
    DOI: 10.1016/j.socscimed.2021.113716
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    1. Christian Schaetti & Mitchell G Weiss & Said M Ali & Claire-Lise Chaignat & Ahmed M Khatib & Rita Reyburn & Radboud J Duintjer Tebbens & Raymond Hutubessy, 2012. "Costs of Illness Due to Cholera, Costs of Immunization and Cost-Effectiveness of an Oral Cholera Mass Vaccination Campaign in Zanzibar," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 6(10), pages 1-10, October.
    2. Islam, Ziaul & Maskery, Brian & Nyamete, Andrew & Horowitz, Mark S. & Yunus, Mohammad & Whittington, Dale, 2008. "Private demand for cholera vaccines in rural Matlab, Bangladesh," Health Policy, Elsevier, vol. 85(2), pages 184-195, February.
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    1. Aziz, Sonia & Boyle, Kevin & Akanda, Ali S. & Hanifi, M.A. & Pakhtigian, Emily L., 2022. "Early Warning Systems, Mobile Technology, and Cholera Aversion: Evidence from Rural Bangladesh," RFF Working Paper Series 22-24, Resources for the Future.
    2. Pakhtigian, Emily L. & Aziz, Sonia & Boyle, Kevin J. & Akanda, Ali S. & Hanifi, S.M.A., 2024. "Early warning systems, mobile technology, and cholera aversion: Evidence from rural Bangladesh," Journal of Environmental Economics and Management, Elsevier, vol. 125(C).

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