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Matern Child Nutr. 2018 Apr;14(2):e12518. doi: 10.1111/mcn.12518. Epub 2017 Sep 28.

Willingness to pay for small-quantity lipid-based nutrient supplements for women and children: Evidence from Ghana and Malawi.

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Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, California, USA.
Department of Agricultural and Resource Economics, University of California, Davis, Davis, California, USA.
Department of Economics, School of Economic and Business Sciences, University of the Witwatersrand, Johannesburg, South Africa.
School of Public Health and Health Systems, University of Waterloo, Ontario, Canada.
Department of Nutrition and Food Science, University of Ghana, Accra, Ghana.
School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi.
Department of International Health, University of Tampere School of Medicine, Tampere, Finland.


Small-quantity lipid-based nutrient supplements (SQ-LNS) are designed to enrich maternal and child diets with the objective of preventing undernutrition during the first 1,000 days. Scaling up the delivery of supplements such as SQ-LNS hinges on understanding private demand and creatively leveraging policy-relevant factors that might influence demand. We used longitudinal stated willingness-to-pay (WTP) data from contingent valuation studies that were integrated into randomized controlled nutrition trials in Ghana and Malawi to estimate private valuation of SQ-LNS during pregnancy, postpartum, and early childhood. We found that average stated WTP for a day's supply of SQ-LNS was more than twice as high in Ghana than Malawi, indicating that demand for SQ-LNS (and by extension, the options for effective delivery of SQ-LNS) may be very context specific. We also examined factors associated with WTP, including intervention group, household socioeconomic status, birth outcomes, child growth, and maternal and child morbidity. In both sites, WTP was consistently negatively associated with household food insecurity, indicating that subsidization might be needed to permit food insecure households to acquire SQ-LNS if it is made available for purchase. In Ghana, WTP was higher among heads of household than among mothers, which may be related to control over household resources. Personal experience using SQ-LNS was not associated with WTP in either site.


Ghana; Malawi; demand; small-quantity lipid-based nutrient supplements; willingness to pay

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