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Infectious Disease Risks In Developing Countries: A Non-market Valuation ExerciseSamajpati, Shreejata 01 January 2012 (has links)
This dissertation focuses on the non-market valuation of health-risks of malaria, an infectious disease that imposes a substantive public health burden across the globe, hitting particularly hard the tropical developing nations of Africa and Asia. The United Nations Millennium Development Goals include malaria control as a priority and large investments are underway to promote effective prevention and treatment. Despite such concerted supply-side efforts, malaria-related mortality and morbidity still abound due to a complex interface of factors like climate-change, poverty, inadequate control behavior, infection and prevention externalities, parasite resistance etc. This research project digs into the demand-side of the health problem, considers the "externality" dimension to prevention, and primarily asks the question: how do individuals in developing countries view competing disease-control (prevention) measures, viz. a publicly-administered community-level malaria control measure as against private preventive choices. A theoretical model is developed to help explore the public-private interplay of health risks of malaria. The malaria-endemic regions of Kolkata (India) and its rural fringes comprise the site for an empirical investigation. A field survey (Malaria Risk and Prevention Survey, October-December, 2011) incorporating a mix of stated and revealed preference techniques of health valuation is implemented. Risk-perceptions of respondents are elicited using a measurable visual-aid and individuals' perceived valuations of health-risk reductions, randomly offered with the public and private health treatments, are empirically ascertained. Using a Likelihood Ratio Test on the structural risk parameters, it is seen that individuals’ valuations of health risk reductions are the same across the private and public treatments. The comparative valuation iv exercise, thus, corroborates the externality dimension to malaria control, calling for greater public action to combat malaria. The viability of such a scaled-up public malaria program, in the context of Kolkata, is discussed by comparing the public treatment willingness to pay estimates with the annual estimated costs that the Kolkata Municipal Corporation, the civic body in the city of Kolkata, maintains on account of vector control. Results from the comparative valuation exercises also support the idea that private prevention is generally responsive to prevention costs, indicating the importance of price incentives to induce greater prevention. The issues of health valuation and price sensitivity are further explored across various split-samples differentiated on the basis of socio-economic attributes, disease exposure, actual prevention efforts and perceived malaria risks of survey respondents. Such auxiliary exercises help analyze the valuation question in greater depth, and generate policy insights into the potential factors that shape private prevention behavior.
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