Using assessment of willingness to pay to improve a Cambodian spectacle service

Aims: To assess willingness to pay for spectacles in provincial Cambodia, and use this to inform creation of a financially self-sustaining spectacle scheme within a blindness prevention programme. Methods: An interview-based questionnaire was used to elicit willingness to pay for spectacles of all people dispensed spectacles during an outreach refraction service visit to three village health centres in Cambodia. Results: Of 293 people participating in the study, 252 (86%) provided internally valid willingness-to-pay responses from which data were analysed. 76.6% (193) were willing to pay at least KHR1500 (US$0.38) for spectacles. On multivariate analysis, an increased likelihood of being unwilling to pay at least KHR1500 for spectacles in the future was significantly and independently associated with being ⩾60 years old, attending Kor or Svay Teap health centres, not being an income earner in the household and having a household monthly income of less than KHR50 000. There was no association with being vision-impaired, this being the first eye examination, occupation, not having motorised transport or previous spectacle wear. If the potential willingness to pay had been converted to actual on the day, there would have been a 28.0% increase in revenue, and a greater than fivefold increase in profit, for the spectacle scheme. Conclusions: Willingness-to-pay data may be useful for price-setting and developing a subsidisation protocol for poorer consumers that will ensure financial accessibility for all and financial sustainability for the provision of spectacles.