Are consumers willing to pay more for biofortified foods?: Evidence from a field experiment in Uganda

Vitamin A deficiency is a major health problem in Africa and in many other developing countries. Biofortified staple crops that are high in beta-carotene and adapted to local growing environments have the potential to significantly reduce the prevalence of vitamin A deficiency. One such example is the orange sweet potato (OSP). Because of its distinctive orange color, which is in contrast to the white varieties that are typically consumed in Africa, it is important to assess whether consumers will accept it. This paper attempts to address this question by using a choice experiment with the real product to quantify the magnitude of the premium or discount in consumers' willingness to pay that may be associated with it. It also considers the extent to which the provision of nutrition information affects valuations. Finally, the paper addresses whether the use of hypothetical scenarios is justified in a developing country context, and quantifies the magnitude of hypothetical bias that results as a consequence. We examine whether a “cheap talk” script, which as elaborated in the paper, reminds respondents that hypothetical scenarios are to be treated as if they are real, is effective in mitigating hypothetical bias. The experiment was conducted in Uganda, a key target country for the dissemination of orange sweet potato. Our results suggest that in the absence of nutrition information, there is no difference between white and orange varieties in consumers' willingness to pay, but there is a discount for yellow sweet potato (which does not have any beta-carotene). The provision of nutrition information does translate into substantial premia for the orange varieties, indicating that an information campaign may be key to driving market acceptance of the new product. Finally, there is a substantial hypothetical bias in both the willingness to pay (WTP), and the marginal WTP, for the new varieties; while “cheap talk” may mitigate this bias, it does not eliminate it.Cheap talk, Field experiments, Hypothetical bias, conjoint analysis, Universal logit,

A rare case of cervical fibroid presenting as retained placenta with postpartum hemorrhage

Fibroids during pregnancy are often asymptomatic but sometimes may lead to various complications and unusual presentations. We are reporting an unusual case of cervical fibroid during pregnancy that presented as retained placenta with postpartum hemorrhage following a full term normal vaginal delivery

Using elicitation mechanisms to estimate the demand for nutritious maize: evidence from experiments in rural Ghana (HarvestPlus Working Paper No. 10)

In this paper we assess (a) consumers’ willingness to pay (WTP) for a recently developed variety of maize that is high in provitamin A in the context of a public health intervention and (b) the performance of three elicitation mechanisms in estimating WTP in a field experiment in Ghana. The mechanisms that we used for elicitation are the Becker-DeGroot-Marschak (BDM) mechanism, kth price auction, and choice experiment. The basic design of the experiment involved random allocation of consumers to one of three elicitation methods. This was augmented to include treatment arms to address the effect of (1) participation fees and (2) nutrition information on WTP. Estimation of BDM and kth price auction models that account for censoring of bids at the market price for maize (kenkey) and estimation of a conditional logit (CLM) model for the choice experiment that accounts for lexicographic references yield estimates of average WTP that are similar in magnitude across the three elicitation mechanisms. Variation in participation fee has no effect on estimated WTP in the two mechanisms that varied participation fee, suggesting that people did not have a higher propensity to spend out of windfall income. In the absence of information on the nutrient density of the new maize variety, subjects are willing to pay less for it than the existing varieties; however, nutrition information transforms this discount into a substantial premium

A cluster-randomised trial comparing home-based primary health care and usual clinic care for epilepsy in a resource-limited country

OBJECTIVE: To ascertain whether home-based care with community and primary healthcare workers' support improves adherence to antiseizure medications, seizure control, and quality of life over routine clinic-based care in community samples of people with epilepsy in a resource-poor country. METHODS: Participants included consenting individuals with active epilepsy identified in a population survey in impoverished communities. The intervention included antiseizure medication provision, adherence reinforcement and epilepsy self- and stigma management guidance provided by a primary health care-equivalent worker. We compared the intervention group to a routine clinic-based care group in a cluster-randomised trial lasting 24 months. The primary outcome was antiseizure medication adherence, appraised from monthly pill counts. Seizure outcomes were assessed by monthly seizure aggregates and time to first seizure and impact by the Personal Impact of Epilepsy scale. RESULTS: Enrollment began on 25.09.2017 and was complete by 24.07.2018. Twenty-four clusters, each comprising ten people with epilepsy, were randomised to either home- or clinic-care. Home-care recepients were more likely to have used up their monthly-dispensed epilepsy medicine stock (Regression Coefficient: 0.585; 95% Confidence Intervals, 0.289 to 0.881; P=0.001) and had fewer seizures (Regression coefficient: -2.060; 95%CI, -3.335 to -0.785; P=0.002). More people from clinic-care (n=44; 37%) than home-care (n=23; 19%) exited the trial (P=0.003). The time to first seizure, adverse effects and the personal impact of epilepsy were similar in the two arms. SIGNIFICANCE: Home care for epilepsy compared to clinic care in resource-limited communities improves medication adherence and seizure outcomes and reduces the secondary epilepsy treatment gap

Developing country consumers’ acceptance of biofortified foods: a synthesis

The success of biofortified staple crops depends on whether they are accepted and consumed by target populations. In the past 8 years, several studies were undertaken to understand consumers’ acceptance of foods made with biofortified staple crops. Consumer acceptance is measured in terms of their sensory evaluation and economic valuation of biofortified varieties vis-à-vis conventional ones. These studies apply expert sensory panel and hedonic trait analyses methods adopted from food sciences literature, as well as various preference elicitation methods (including experimental auctions, revealed choice experiments, and stated choice experiments) adopted from experimental economics literature. These studies also test the impact of various levers on consumers’ evaluation and valuation for biofortified foods. These levers include (i) nutrition information and the media through which such information is conveyed; (ii) the length and content of nutrition information; (iii) different branding options; (iv) the nature (national or international) of the branding/certification agency that is endorsing the biofortified staple food; and (v) the nature (national or international) of the agency that is delivering the biofortified staple food. This paper brings together evidence on consumer acceptance of biofortified crops on 5 crops across 7 countries in Africa, Asia and Latin America. The results of these studies are expected to aid in the development of biofortified crops that consumers like, as well as in the development of appropriate marketing and consumer awareness or information campaigns to encourage the switch in consumption from traditional staples to biofortified ones

Methods matter: a meta-regression on the determinants of willingness-to-pay studies on biofortified foods

Following the growing evidence on biofortification as a cost-effective micronutrient strategy, various researchers have elicited consumers’ willingness to pay (WTP) for biofortified crops in an effort to justify and determine their adoption. This review presents a meta-analysis of WTP studies on biofortified foods, either developed through conventional breeding or using genetic modification technology. On the basis of 122 estimates from 23 studies (9507 respondents), consumers are generally willing to pay 21.3% more for biofortified crops. Because WTP estimates are often determined through different valuation methods and procedures, a meta-regression was carried out to examine the role of potential determinants. Aside from contextual factors, such as type of food crop, target nutrient, and region(but not breeding technique), various methodological factors significantly influence premiums, including the type of respondent, nature of the study, study environment, participation fee, and provided information. The findings allow researchers to better anticipate potential methodological biases when examining WTP for (biofortified) foods,while it gives policy makers a broad understanding of the potential demand for different biofortified crops in various settings