Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment
Abstract Background Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction. Objective The objective...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | Health Economics Review |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13561-024-00497-4 |
| _version_ | 1797247499258298368 |
|---|---|
| author | Olujide Arije Jason Madan Tintswalo Hlungwani |
| author_facet | Olujide Arije Jason Madan Tintswalo Hlungwani |
| author_sort | Olujide Arije |
| collection | DOAJ |
| description | Abstract Background Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction. Objective The objective of this study was to elicit, and derive relative valuations for, attributes of SRH services that adolescents and young people value, and their willingness to pay for these services, in public health facilities. Methods A discrete-choice-experiment (DCE) that was developed using a mixed methods approach was administered to AYP from Ogun State, Southwest Nigeria. The DCE attributes were: the type of staff; physical environment; health worker attitude; cost; waiting time; contraceptive availability; and opening hours. The choice tasks had two unlabeled alternatives and an opt-out option. Panel mixed logit choice model was used to fit the choice data, along with estimation of willingness to pay (WTP). Also, a latent class logit model was used to detect underlying preference heterogeneity among the respondents. Finally, the uptake of the services in health facilities was investigated by estimating the probabilities for selecting hypothetical health facilities under different scenarios. Results A total of 859 AYP participated resulting in 6872 choice observations. The physical environment attribute had the highest utility rating relative to the other attributes, followed by preference for a doctor and for a service provider who was open and friendly. The cost and time coefficients were negative, revealing preference for lower cost and shorter waiting time. The latent class model had three classes that varied by their background characteristics. Probability of choosing any of the facility alternatives increased with introduction of more favorable facility characteristics. Conclusion The pattern of preferences identified are potential targets for service design and delivery optimization that may result in improvements in service acceptability and utilization. These results strengthen the call for involving AYP in decision-making in health interventions for them and developing context-specific SRH programs for AYP in public health facilities. |
| first_indexed | 2024-04-24T19:59:40Z |
| format | Article |
| id | doaj.art-d04217c7ca43408d9e7d641f84ee8552 |
| institution | Directory Open Access Journal |
| issn | 2191-1991 |
| language | English |
| last_indexed | 2024-04-24T19:59:40Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Economics Review |
| spelling | doaj.art-d04217c7ca43408d9e7d641f84ee85522024-03-24T12:10:15ZengBMCHealth Economics Review2191-19912024-03-0114111610.1186/s13561-024-00497-4Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experimentOlujide Arije0Jason Madan1Tintswalo Hlungwani2Institute of Public Health, Obafemi Awolowo UniversityWarwick Medical School, University of WarwickSchool of Public Health, University of WitwatersrandAbstract Background Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction. Objective The objective of this study was to elicit, and derive relative valuations for, attributes of SRH services that adolescents and young people value, and their willingness to pay for these services, in public health facilities. Methods A discrete-choice-experiment (DCE) that was developed using a mixed methods approach was administered to AYP from Ogun State, Southwest Nigeria. The DCE attributes were: the type of staff; physical environment; health worker attitude; cost; waiting time; contraceptive availability; and opening hours. The choice tasks had two unlabeled alternatives and an opt-out option. Panel mixed logit choice model was used to fit the choice data, along with estimation of willingness to pay (WTP). Also, a latent class logit model was used to detect underlying preference heterogeneity among the respondents. Finally, the uptake of the services in health facilities was investigated by estimating the probabilities for selecting hypothetical health facilities under different scenarios. Results A total of 859 AYP participated resulting in 6872 choice observations. The physical environment attribute had the highest utility rating relative to the other attributes, followed by preference for a doctor and for a service provider who was open and friendly. The cost and time coefficients were negative, revealing preference for lower cost and shorter waiting time. The latent class model had three classes that varied by their background characteristics. Probability of choosing any of the facility alternatives increased with introduction of more favorable facility characteristics. Conclusion The pattern of preferences identified are potential targets for service design and delivery optimization that may result in improvements in service acceptability and utilization. These results strengthen the call for involving AYP in decision-making in health interventions for them and developing context-specific SRH programs for AYP in public health facilities.https://doi.org/10.1186/s13561-024-00497-4Stated preferencesDiscrete choice experimentAdolescents and young peoplePanel-data mixed logit modelLatent class logit modelOgun State |
| spellingShingle | Olujide Arije Jason Madan Tintswalo Hlungwani Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment Health Economics Review Stated preferences Discrete choice experiment Adolescents and young people Panel-data mixed logit model Latent class logit model Ogun State |
| title | Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment |
| title_full | Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment |
| title_fullStr | Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment |
| title_full_unstemmed | Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment |
| title_short | Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment |
| title_sort | preferences in adolescents and young people s sexual and reproductive health services in nigeria a discrete choice experiment |
| topic | Stated preferences Discrete choice experiment Adolescents and young people Panel-data mixed logit model Latent class logit model Ogun State |
| url | https://doi.org/10.1186/s13561-024-00497-4 |
| work_keys_str_mv | AT olujidearije preferencesinadolescentsandyoungpeoplessexualandreproductivehealthservicesinnigeriaadiscretechoiceexperiment AT jasonmadan preferencesinadolescentsandyoungpeoplessexualandreproductivehealthservicesinnigeriaadiscretechoiceexperiment AT tintswalohlungwani preferencesinadolescentsandyoungpeoplessexualandreproductivehealthservicesinnigeriaadiscretechoiceexperiment |