Willingness to pay for health and water in rural Mali : do WTP questions work?

PHN8702 tHN Technical Note 87-2 WILLINGNESS TO PAY FOR HEALTH AND WATER IN RURAL KALI: 00 WTP QUESTIONS \fORK! by Nancy Birdsall and PunAIII Chuhan Originally issued in Country Policy Department Discussion Paper No. 1983-8, February 1983. "Three St'~dies on Cost Recovery in Social Sector Projects. M Reissued January 1987 Populatio~, Health and Sutrition Depart~ent World Bank '~e World Bank does not accept responsibility for the views expressed ~rein w~ich are those of the author(s) and should not be attributed to che World Bank or to its affiliated organizations. The findings, interprptations, and conclusions are the resul'i:s of research supported by the Bank; they do noc necessarily represent official policy of the Bank. The designations employed. the presentati0n of ~terial, and any maps used in this docunent are solely for the convenience of the reader and do not iI:lply the expression of any opinion whatsoeve,:, on the part , of the 'Jorl::! Bank or- its affilL:HCs concerni!1~ th~ le~al !-l"aLus of ~n\' country. territory, cay ared, or of its authoricies, or .::oncerning thE' delimitations of it5 boundaries, or national affiliation. I ,....'  PH~ Technical Sate 87-2 WILLINGNESS TO PAY FOR HEALTIi AND VATER IN RURAL HALl: DO VTP QUESTIOSS WORK? A B S T R ACT The paper revieIJS evide:1ce fro:: a household an':' com::luni ty sun'ey ina poor rural area of ~.ali regarding the ability and IJillingness of residents to pay for potential neIJ health and IJat~r supply services in their co=~unities. A si~?le ~odel of household demand fer such services is presented; the oodel e!:l?~asizes the i::portance of distapce to services and th~ ir '1uality, a!:. Ilea as fee!'! ('~a,ge\:, b infl'Jencin\1: de::anri. Tests of thE validity ot wil!.ingness to ;:.ay data, 1.-:. -:a::a obrai:-.<2d by direLtly asking respondent .hat they IJouU ~ IJilling to pay for such services. are apl,lie.1; the tests use a:1alysis of data on expenditures for substitute services to coupare i;:;co~ and "price" (i.e. di.:;tance and quality) eLect.;. These tests sug~est the \;r? data are reasonable, particularly for IJa :er. The absolute a::lOunts are such as to sugr;est that the costs go·:'ern:n.ent hopes to recover at the local lev~l couln be obtained in nost th,)Ugh not all the survey villages IJhere health and IJater projects are pl mnei. * * * * * * * * * * Prepared by: ~ancy Biresall and ?unam Chu~an Population, Health and Sutr~tlor. Depart::ent This is one in a series of p~?ers pre?ared under Research Project 672-72: Demand tor and Wil~ingness to Pay for Health and Schooli. in Mali. Originally issued in Country Policy Department Discus~ion Paper No. 1983-8, February 1983, "Three Studies on Cost Recovery in Social • Sector Projects." Reissued January 1987  - ?aile ttlt rod! Ict!.)tl 1 Sectiol:: 1. I..:lcor;:crat1:::.g ::ser Ftes i~to .~ Household :.t:::..and ~od41 3 Sect1c :l 2. 10 ~ct!O:l 3. Seetio:l 4. :.at.a A.::'.4:!.ys:!.s 21 SeCt.iOll 5. 33 Ra!are nees 40 Appec.c1x A. A Eousehold De:::..aed XOdel 42 Appenc.1x 3. Vali~it7 ~ests of _11!!:::.gness :0 ?ay Daca 44 Appecc,ix4' "'a::i.?!)l~ De.!!.::.1:!.o'C.S. ~a'Q.S .and St'.3::.d4:-d )e vi... ::!. ., 'C.S 46 . oth.r seM'ic'.dil 1.Ihich r-..a'l"e "::>ee'!:l j)rovicied :0 use::-'i at :'0 c:::..a:ge or at ~g:-':y subs1:l1zed rates. 1/ Ci·...~n j)ro~ections of slo-:.:er et".OL.::::lic gro'W~h aold ::-.! conti:tuiCi c.i.f!ic'.!l:y of gove:::rctnts in ::a1si~g ge~ral ,:e·."I!~ues. :al.nte:-..a:,:ce of su::h s.er.ices. :.e: alo::.e :~e!t e:.'!:;:an.sion and !.:J'iH'ove:::ant. Io"ill -onl:' '::e j)oss1ble it there a::e substantial 1:::1prove:::ents i:l efficiency a::::d ::'I.:.S ':ecli:::es in un:L t cos ts. or 1.! a g::.-ea te r share of cos:s a:e t"e co·te ::ed di re c :11. -::::-. :CLlg:'. This ;:aj)e::' is cOllcer-..ed j)ric.a:i11 lI1:h :b.e second option of g::-ea:er cost ::eccve::Yj 1:.1 it ::e'1!.e.:s evidence :'!'c:: a household a::lci CO=uP.!.:l St;::-:ey ,~ a. "o<r l:'"~ral a::ea of :.;es: A:::"i~ ::egJ.:::':i::::g :!-.e a:: 11.::" ':1 a::ld w:.lling:::ess of ::o=un.ic!.es. houSI!:noLi cie::.a:.d :or such se::--... ices is j)::,ese:::.ted. ~ :ecel. s'..:gges:s. a !rac.~,·.or.<. ::lI:' aC411:::i.::::g :!-.e ?Ote:::.tiaJ.. effects 00. :::e:::.a::ld of !.::::creas!.::g use::­ !us fo:: a. sa::--."!ce. and :;;;,:: a::-..al.1:.!:.g ::.:-'e i:i'l!.ca::'o::.:> of .fe",s for e!:!c::'e::cy s!.~ :.1 uic._d t:~e aount: :!'I.Y lo.:lul::1 ':e Ii:''::!:' :0 ilay !;,:: " 6,:)04 :t' U:-":'::'!. ~. I.c."la.:luges of t:~. 1lil..l.!.::.r-u.s-:;)-'''1 .&?pt'c&<:!1 and a :u: o! :~. !.:$ va.U. :~1 =1 t:~at u.s., :!le &':'&':'1'5i.s o! .r;:e:ct!. :;.:.re da:.1, a:oe oc.:l!.:e<i. I~ Seet!on 3, :he sUr"ley d~:a \=4 ,et:!:g in ~~r&1 ~~.:.! a:o_ dese::-'1':lad. &ad :::'e ::.a~:\:.I!e o~ the .::')scs associated 1rl.:!1 :,la.:l:!ed ~a'" ~cal:~ and '4:.:' SUP? l] "r':) ~ec ts !os :lu:!.!:a<1, e::;ha.s!:!::.g :~e :0<:&1 :.c;.:.r:'1::1 : ::)5:: 3 ~acl'~!oas Y1:~ :espec: :0 :~e "lal!d!:y o~ :~ • •~? da:a, ~:4 :~.!: !.~l!ca:ioas !or :he ill4:n~ 't'~~ec:s !.~ :~e ~~li ,ec:~~g, .&:. ?rov!.!_d ~::. Sec:!on S.  - 3 - diag::.ost:"c ser-.,ices .::I..:! ::ec.!:!.nl!, a::.c. of t:!.~ to t::avel to ~te.-e ca.:'1! a~'" drug:1 are a7ai:"~l.e; a:::.d. tor '4ter, 0: C3.sh a::.c. t!.::!lI to ::a!::.::ain :'o:::.e 'WlI!:'':'s, For given :::or':lid!ty (SCt::ll ?O:,,:!.on 0: Ilt-...!.c:' is :'a:ldoQ a::.d sc:.a ~o:::!on 0: .... h:':':\ - function 0: r~use~old !::.:::e, and. :::e :"" ­ rt""' ..... ""0'. '-­ of Iir"gs I cos: oi ·... ::5 tJ.til!::.u:!.nl.  - .5 - ~: \ \ I ) J . t \ , Q Q Ot o ~ I f\l I I .g ~ I ~ o~ Q­ - \' -0 \ U.  J _ !.s :'':'!Ll::' "::a.: to:.) .. :, ~·.!::~e: • I. sec::::, .- ..... ... - -~. =~es ·:",.ea::~ , sc~col!:g. ..... -_ ..  7 u..njusc!:iu:! • ::-.e e:x:e:l: conscra!:l::s. :::-;csec ce::.ao.c:i • , - !is::ao.ce. ~.e . .. ::..a «:45::i::!:: ;;;! .. .... "'" ... \,.~ ... "" - ::-.e se :'".:.. ~e s c!.!.s :a.::.ce <'-­ ,-,.; :.:.:: :':'e :'0: ... :::.::::'eases ......,_-­ ::0 ::-.e e,;:e:::: :::a: :::.e ;::::0::' ... ':':ea:':.- :'..a..:e access ::;) se:'"::'ces  3 coats of ,!:~!~:a:!cn. ~~!l !ees cove: :os:s? costs. )  - 9 ­ boo~s. and subsistence 0: 'Tillage-level _or:<.e:s. ::-.e :!i::e=c~'ce :"s i::.?ct:':a:::; to j1ersoc.nel. costs and i: ~o cccple::enca:: i::l?ut,9 such 3.13 supplies. l:,:{ As a practiC-.ll :a::ter. it is o::er: t~ese coc;l.!.ecenca:.-y i::;:u:s :::'a: ~=e s::ortc::'a:..~e:i i::1 :,I-..e :ace of a cellc:al g':)ve:-..:::ent spenC:i:::.g cot".strai:J.t; i : :",9 ;,:s'":,,,::', ye::' tr.e. locg r".1::1 given political co r.siC;.! rations. 7:.e result can '::>e a d:a::.at:ic <iec :.i:::.e in the qual!. ty of :!".e se ::-nc':.;. !.! fo r e:o:a.=p le a t·.1~-el:' is :'.0::: :r..ai:ltaic.eC: a:'l.d does noC ·.;or~; or a d:a:atic ! .... c:ease !:on :::-.e dista:-.ce • .::;~':':-':.e cl.!l!ncs ,zed to travel :0 ut:!.11:e a s.er-.r!.ce. i! fe-r e:o:a.=ple !-..eal.th ?e::'s::m"e:' ca: ::ot tra.vel for lack of f'.!el or ·/ehicl.es th.;o.: are ....orkin;. ~e :'..a':'::. su-':ey co~ld :'.oC use -"o!:1 C1.!.I! :0 ':::reakcolo-n or lack. 0: ga.·oE:::e. .... ::::-.e 5a::.e t:'::e, ·"O"k.!.o~ day and ·.;eek '::>e:ore t::e sur-ley, :::e fac.!li:ies c:'osest::- . . .e S.i::'?:~ vi.",:ag~s (on average 50 ic:.ilocete:!I a ....a:d trea:ed :e·..;e: :::a:lc::a ;;-e:SC:1 ;:e: ~ ::sotl-hou: of health sar-r..::es c::e:ed.. 12:' -;"-r.a': :h!.3 i::.?:':"es is :::30: a ~:;~a:.=e :ac:o:,.  ... -.4 t: _ _ -: . ::-:e se:-r.. ce a~d as an i=dica:~~ ";1!I.7)·  11 the pote::u::!.a.l cie:::.a~d ~or t:'e :.e .... service. Ccn:n:.::.ers:.ay 'be ·.'111::':.g to ?a:, for: tuee ....lIl11s but :lOt ~or use Jt shall.t. ·",,:ls. F!.:-.a.1ly. ex.!sti:-:g ::1=..i..:a.: services =.ay ~ot charge a:1Y fee, or ;:,ut a.:lother lOay. ::!:e::e is often ::'0 'l3.r1ation b fees (if se:vices are f:-ee); ·...1thout variation 1:1 fees t::e:e is ::.lay be d.!!!!.c'.11t a:::d er;ec.sive ::0 ::easu:;e .led capture var!.ation i:::. c.u.a1!.::y or: :!.:1 dista~ce of ex!st:!.~g ser7:!.ces .i::~out !a!.rly sophis::icated sa=pl!.~g and qUAst!.on=aire ~sign. :0 elicit ?re!ere:1ce !~nc::!~ns for publ!.c goocis su~ as better ai: quali::y or \Ii.dl:!.fe preset"':es i:::. :!evel.::peci. eco::.o::lies ~3/, a-::d 'Ter:',I t"ece:l:::Y, ::0 es::i:::.ate '..r!.ll!::.g::-.e!! to ?a.y for hcusin%, se:"v:!.ces !.:1 ':eveloping econcc.:!.es. 14/ -::::'e <!??rcach. is 0: course j::<ir':icu1a :1'1 useful i:l the case of ?ublic goods ·."he:-e :-evealed. :::. a:1 acalogous '.-ay i : is also ?ote:l::!.ally useful i:l de'lelopi::.g ·~te: supply a.nd education -- .tich =ay :let e~:!.st at all 1:1 certain re~i:~s, or =.ay ~ o::ared at suc~ 10.... quali:: or: such grea:: ciis::ance ::0:::' ?otent:!.al c:"ie:l.ts :::::a:: there is :!.:l effec:: no =ark.e:: for ::he set"'r..cp. gcve~en: ::.!.g~:: ::.el.ll:r ?lac ::0 ,,::o'l::::'e, .Jl!or a.s sugges:ec above. =.ay 'be "rovided a: :':.0 c:-:.a:ge 3:1d :~us ""'i:::out :::'e ':ar:at:::::::;, !.:l fee :ectu.i:ed :0 es::i:::.a::e :::e effect :f :ees 0:'1 c!e=.a::.ci. 7::ere re::.a:::.s. ho'.:eve:, cOl:s:::cierable s~pticis::l, ...... r::.i.:".Jla::ly a:ong ~:::ot'.ot:1is:~, ajout ::::..e 'laEci:y cf a:oun:s "Ucitad by ::'!s :::p >I..cci, ·.;:t~ eonce~ :oc".Jss:!.::g on several ?oss!.'::lle ::::;::es of response bias. '::lese i::c':\,;<:!.: hy?cthet.i.: ~ias -- :hat responcents' ans~ers '~ll ~ :ean:!.cgless ~ecause ::7~ · ..  - 1J - t.o de!cr1~ t!-..a services be1:lg asud a~out. or to probe on ·.n.:!.!.i:lg::.ess t;:, ;:a:' u..s~~ng the. convent.ional ':::i:i::ll::g for--ac:.. On the :In. hanci, this suggests hy'~ot!-.etic bias could be a ;>r;:,bleo. C:1 the other hand, . , 'f:.nov thaI: in each vi.llage. groups of vil1..~ge:s ..e:e :rought to&ethe: to have the put70se of I::-'e gcvel:""'..::.e::.t Io7lS eonsicie:!:::; i:::.stall!::.g !-..aalt!l serv!ces anc. :ube',"ells in villa~s and :!-..a nature of those servicas, vas aXj:lla1:::.ed. ~u..s it is l.!.k.ely c:.hae :1!.s-;><lndants had a :1!.asor.ably elear icea of :::'e proposed services bei=g a:lud about. and that tl::.!!y d!d not v!eW' the situation as hnothaticaL ~ fac: of c.:.... se village la':el c'...1scuuiot'ls, nOW'evt:r, ':'ces sugge!': t:laC a second sor: of :ias, st::aceg1c bias, ':lUS: be considered. Etesponc.e:::l:s ::,ive c.:;) ~y ::-.e a:::ount ::-'ey stated or an a.::.oune '::.ased on :he1::s a:::.d ot:-'e: lespcnde~ts' stac.e:en:s. l1! S::ategic bias is also probably a g:e~:er ::ons:.::pt10n ':::1 oce ;:a=:1, a: sooe (loi::t and :0 sooe e:.otte::.t. precluc.es !let'''nCe! (and !:oa a:l e:!ic.iency poi:::.::. of vioa'J, :o::e likely t:-..a: pricing ::ased IJn ::oarginal cos: is -a.:-:an:ed - :l::.ough not :-..ece!sa:!.':': exact::'y at ::.a:gi:-.a:  .. .. . i'r:~e.e :J!1 :!':e =!ghc:-!:1.a::.d s!:!e o!. :!':e equa:!c::l, a!oeg ',n:!:1. d!s:.t:;:e a.::.c! ,. !os  15 as C:Ul e:tf)end.!.ture equat!.o::.s ....h1ch thay ::.at;;.h. rllla.be t:.l'::>e ....el!. :1"..e !.::.!n-...at.!.on Oil hou.sehold ex;::e::1.c.!.:'..!res ~s en :he oc:h(:: SOOI va:', substitutes !or :::.. hyt)Qthet!.ca.l servi:.es. A.Jj a. t'esul:. ,. ::.aus ::l.O s4nse to cc':?a.re :::~ a :solute a::.ou::.:s c: .. I 2. S1.:Ularly,!.s the effect of educat::'OIl acd of oche:: ~Cc! oer:-::co,:,:,: var:... bles !.:l the sa:e c!.rectioll? for each ether, are t~ ";:::-::'ce" var!.able.s of act~: se:--.-!.ces. ~::,:c,!,'... d:!.:,.g ho\'.seholds res!.c.!:::g close:: to a ~al:h c!.!.s;::e:::.sa.:: a:.d c.r-.:g cutlet? :5 '.." ,:? :0:::  Section 3. on: Ie S ::.::..a. : ! :::~  - ,­ l. t - d!sta:lcl~ ::'C'C1 c:-". villaga !.:l .... hieh eaeh household !s loca::ec. :0 the cearest: Ii:--.lg outlec (a s:.a:.e j:)hat""'...aey, a scatl! - s?onsored cooperat1vu 5e111:g drugs, 0: !.~ a :e.... cases, a ~r!.'1ately- -Jher~ drugs are available - d!..scanee :0 ::~e :::IIarest h.l!al:~ dispecsa::-y, ei:he:, publ!.:. ,:r r;ypes of healt:~ care of ~~ll!!.cao;:!.o~s of sta!!, availabllity of supplies, clea~!.~ess of :ac!.l!.:!.es .t!ld ot.~er .:=--a rae: .. rist!.c!. ar:d ':lased on the =t:::boer of village 1.1IIl1!.s per iGeO ?o,?ula:!.oc. adt:U:l!.st.rat.!. .... discrieo;:s, or ":.erc!es", 0: t.~e F'.ayes :-:!gion: '!.a.:ou!a!>e, :ra::spor: ::"5 ex::e::ely :::'':::':::\1:: at a:: ::":es a.nd for so=- \r-:'::ag'!s !.:?oss!.::e dur:,:l8 :::-.e :-ai:lY season; :h.e -r..llages :he:selves are s:t:Iall, -.n:~l a!::out. seQ  !d.u.ca.::!.ot'.l!. S:.1:·~.s :'S .1':'50 :':'10'. households ~u:veyed. :e;o::ed :~ey ~e:e :'!.:e:a:e. 1­ sc~co::. •  19 ­ gover':.!:::: :~ st.:.?port the :..-:.:": ~1..11;..-:.re :-ec:;:':-t~t costs .tssoc..!.ated ....::!1 l.nsta IJ..1::" c~e ::&101 ser-l!ces; co=unicy S1.!;>;>or': :5 t::'us c:::.!.cal. :0 :~e :'0::'.6­ run f:.::.&r.:ia.l v!a.b1l1:y c.! t~ ?ro;ect!'. !".ajor ::-e;::a!::! ·~"il.l :.e !i:::.a=.c.'!d :~rough ct:::t:,al gove:-...::e:::.: su?por: of sk.!.l:ec! repair tea:"; hCI."ever:he costs of ~:::or re;:&i:-s alld. servici:::g 2.:lei of s?are part! are t~ :.e covered :y local, co::un!ty contributions. ~ S?4:-e ?ar:3 are t.st1=.a.:ed :0 cos: a:ou: 10 ,000 ~ a yea:: (550) and ?ay-...e::::s to a .... :1.1..1ge blacl:..s::.i~~ !or :!::.or ::-e;:a!rs a=.d ::::.ai:lteca.:lce and co a s~ni:at!.o::: ".-orur for UP~'i? at ~i!.:lc!:lg acei eira:: ..q ;e, about ::'0,000 v.: a year. :=. addition, vil1,l.gers ·~"!.1.1 :::e 'lsud :0 :::.at.!.'ou:e about Z:)O,CGO ~ t01o:3.:':' i.:.vest:;.-:t:.: COSC!I; asst.:.::.!.::g " :e::1-1ea.:: :!.!e of the '~-e.!..l, 'I."e use aa ac!d!:!.or'.al yea:,ly f:!.gtll:e d :o,ceo XF. ~·..:s :.::ta1 yearly co::.t=!.~u:!ons ::.us: a::cu:'.t :0 ?eo;:Le; ::105: ..·n.:..ages • :-.a.... ~?u1ations closer ::0 lOCO ?e0?!e. ",.e c.e::.1te hou! eho:.:'" ;;i:! :.e aceqt:.a::e:y ser-.re:. :=e ~al:~ ?ro;ec: i::cl.udes ?la::..s :or t:'a.!.:i=.g one or =.ore ~al:!1 wori:ers ::':c eac~ '.r!.!.:age. :.::. ?r::lvice ::":'::'0: :l.l::a::::...... se't"r..c!.s (cu:::s a::.d wo~nc.s, spl:.:lCi:'!g ::roic:.e.n bones). :::c:~C!1cg ::a!.a.tia :rea:::::e::::, 1.li:~ sup?l.!.es 0: :1ocnres:.r:'?t.!.co. ~:::"'.lgs $"'-':'C::' as u;>l.:1:1 a:'.c. :.~!oroqu.!.=.e, a:1::i ail?Uc.:at!,:;n 0: so:e antl.~:!.c:!.cs. e.g. :or eye ::-ea:::::e:1c. ~.ea!.:~ ·~ork.e::! (;>oss!.·::l:Y :~e ::.a:: a:-.d o!".e '''Oc.iln) ''-:~:' a':50 do :e:er:::a:s of hlgt.-:,!.sic. ;>reg:-..a::;:!e:'l, o:-a: :enyc!::a:.!.cr., ii:'• .: j)ro li:e 'I.'Iu:::!:'.g fOOG. 1 :'::e? s::ou~d :::e l.!.:e:a::e. ?·!.s u:::;:.a",ed ;:o:'oi:-.ec  ,;,a \!se an '5t~::..ated -­ 7ea-::y cos:; "'. .. t .... ~ , _I'>-!I~ 'fi ""'..., v-: • __ , ;;::.s -:'.a:'! :: :-.I! loIeeit, :-.11: ~e" are :'~:t.,:at.). !or 1oT.::er .l.c.d 65,CeO :q !::r ~u,:::~.  - :1 Sec::'C:l", Ja:a A.~alY's!.s Willlngn~ss-to-Pay: Bow Muc~? !;.ble 1 shows the averages of a~sol~te a:OU:lt.5 :,es?oc.:ie:t:s in surveyec hOt!seholds said :~.Y ~.iOuld ~e wr111!.::g Ct'l par toward ::.a!:l:ena::.ce at a village wei: and suppor~ of a 7111age health worker. ~ese a:ouc.ts a:'e also ca~e I!. wat.er i!1 al~ost one and h~l! ::':es t~at !o: ~~al:!:"1. 7:lis 15 =:ns!..!:e~t .......... :~. the rep:)r~s of !!eldworkers, ::ased on village group i:l::en1ews, ::-.a: vUlage:'s were :l!U1:h itore interested in !.::;~n·ov1tlg t~ei= '.a:er sup?ly t:-.an l:l el::,e: better ':,!p.altb. or educat!otl set'7ices. :-::..!s is :ot sur,?r!,:'::.g g!·<e.n that 1::. :;"e ...111ages surveyed, .roce.tl re?<Jrac':y spend as =::.c:. as 5 !':.ou::s a d,y seek!~g water 1:1 the wet season, a:d a ~ours a day!: the d"y season. (3.ecal:!. a:!..!o that v~ llages su:,-J'eyed ':.;e:'e to so:e ex:e:lt t!:cse ::ost likel7 to ::a'le a ;:I'ro'ole::: of ....atf~r scarc!t7') There are 011 average 32 ;:ersons per well, and. =.o::e !:l sOCle v:.lla~es. :bese are s:-.al:.::v !':.a:ld-operated .-ells, dry ::;:' :3 a::d :lore :lotlths of the year. I: is liLaly that 7!llagers a~~ le!s :~t;:es:!d :~ in i=c~ea~!=g t~e quanc!:y of .racer easily ac:.ss!~le. Second, :~e tot~l .~ su:s ::;c wa:e: a~d ~eal:h aoount :~ :ess :~a~ 0'0.. j)e:ce::t of household i::.e::::e. "E'or !':.ea.l:!'l, :he !!g'.::::e is ~:s:a:::!al::, below that sp~n: ~n d~.::gs. :: :~~ s~ 0: s~c~ ho~sehold a:ou~:s ac:oss  - 2: ­ -=a~le 1: ,'::SCl:?~:"1! ...-::.:.:::C::r:SS··:O-?A! :C?. :JA:'A, • ~l,..!~ AC:::A.!. !:c:!::::::~S, :JA-:n A.':O !!!AL~-?..!:...A7'!;:! 5!:'~C!S, ~_U:'\..'i :?.A..':CS ~I Average houuho ld !.:lcome, survey h:)useholds i89,S8: ~..ai::lt.c.a:lce 0: ·,t!:!age ~cal.::1 vil!4~~ , :~h~yell ".:o:-k.:­ Average acc~nt per household 4/ 1525 1104 Average ~41· as percentage of £ve:a~e housaholc i::lco~e .33 ~i:ll:e':1ance cr ;;rugs, :::ocet":l OYn '.14111 a::c! t :oad i : ~: ~.a.!. ~------------------- -----------­ Average ult:uet per household 'J/ 2,033 lS,ti3 AmoUllt as :lerc:e':1t of household !.::c:ooe 4.86 01gii::lS new !.r.l.editur!~son: !-.ousehold ',/ell ~~------------------------~--~--~~,----------------------- AmoUllt div:Lded !:ly LO (usl.::::.i:::g 10: de?r~cia:ioa per ye4r) 2300 c/ al I::l(!l1.ll~es LS households Ili':.ose .'7? !or .ate:' oras :aro, and :;3 ~ot,;seho :is VhOS4 ~C~ heal~~ ~as :_=0; e~eludes 3 ~cus_holds !or ~ater a~~ ~~ ::~ heal:~ where recorded ~~ ~uats .x:eed~~ 30,CCO ~, a::d 1 tor ~ea :~ wherl .1? as 4 ?ropor~ioa of ~:lc:~e lias ve=7 !-.igh. b/ For:3 households :ha: ~ad :hei: ow-n ',/e:1. c/ :1;'.11'. based on ::'e:)o::.5 c: 6 ::cuseholcs ,., :!'\e sa.:::?!.e ::-'... :: :o.ac. :!;,;g­ :::e',; lIe1::; 1::l the rear ?rece::!.:.':.; ,:~e SU::-7ey. 0.1 cr.S. $:'- ,,':lout 6~O !"!:!.  - 13 ­ Ch'i: vil!.ages have t~e abU',:y '.:~ pay for the :se:-T!ce~ pla.::.:ed a.~ pa:: 0: che pr :l~ec:. Though they W'oule! ~c!ll !leed co purchase drugs, presu:.ably 'lC:1l cr ;lVel :i::e and g!ve:l. :::e ;;ouibll!:y ~hat :lore !=ediaa a::e!l:!.o:l. :0 5.::e hed::h needs W'ouid :et:!uce che total !leed for d=ug purchases. ~or i~ 1: sUr?r!s!ng t~at the ~~ acounts a~e !O s~r~ cocpa:e~ :~ dr:lg e~l!.nd1tu:,es. De:.alld for the ~or~ of s1::ple curac! "Ie serv!.:u and pr'l!vent1ve healt!1 services a vU: age W'ot'ker cculd pt'::lv-:::!e :.&y ~ot be so kee::Iy se !o~ health (15:) than f)r ..ace: (8!); and che coef!!c!~!lt of 7a:1at!.::I. 0: t~,e b:~ds on healt!1 h higher. 7able 2 shoW's t!':e :lu::.ber of :e:o bids, :10 t'l:5-P0t:lSeS, and bids over 30,OCO XF (co:p.r.:ed to chI! :ea:\S cf :5:5 and ~ '~O\itl i::. !a.ble 3. :-hese d!ffe:eeces a::-e !.::l ;;a:,: due ::l d!!!ere::ces !:'t !::.:c:::e a:~ ill access to al:e~at!7e heal:!1 services, analy:ed sys:e:a:!cal!.y be!o~.  - ::. - '::'ab::. 2: CCElr.c:n""!' Ot V.u:..-\,,::c~r OF ',."",:? 3::::JS, Axe ?nC!~AG! OF ZZ'?,.O, ::C lESPONSt ~\~ ~-\LIS7!CAL~Y R!GB ·?~C~S~- s~s 4~? :or ~~ For ~~ints~~oe. of ~~ll~ge V~:las. Se.l:~ '.o'.ll 'J~r\(l!:' -,------------~--------,--------------------------------------------------~--------------- l526 1104 8: .. ..... ,~ ., ... ..... o !tds over ~ 30,000 .... ~... ~abl. 3: EOCS!:40~ ~~~:~~~SS 70 ?A! roa ~rE ~\~ ~A~. 3! CZ"C"-Z (:!aHa:1 ::'30<:') 3a':cula~e !(enie:a 2.349 9i3 l466 ';"f:? heal:!1 l757 385 1089  - 25 ­ pay vere hacdled. as ehree ee3~ ~ere led by ehree differene superv:so=s. ~~y variables representing !enieoa and Kiea (~th 3&foulabe ehe base categ~ry) are included in the reg:ession analysis below to control as ~ell as possible for t~s pOSJibility. Willingness-co-Pay: ~~y? rables 4 acd 5 show ehe resules of ordinary least ~quares regressions of the ~LP amounes (col~ t) and expendit~res (in natural logaritncs. col~n 2) for vater and health respectively. ~e :caos and standard deviations of all var!a~~es used in the analysis are shown in Append1~ C. ~ese regress~ons help explain variation in ~~ acr~ss hClIs4nolds; they also provide a basis for co;~a=in~ ~~? to ~x?endi:~=es a~d for testing the validity of the ~L? a:ounts. Table 4 S:10WS that ex?~nditures for ~ater a~d ~L? are both 1 .. cooe­ elastic, with the point est!;at! of .46 fo: eX?enditures above that of .34 for ~L? 24/ ~L? is Qot :elated =0 the variable shOWing the proportion of adults in the household tr~t are literate; ~or are eX?enditures. ~e d~oy 7ar!ables fo: ~orbidi:y (of any household :e=ber in the las: year) :e~d :0 be in :~e s~e direction in both col~ns. :~cugh few are statistically s!g~!ica=~. A greater i~cide~ce of norbidi:y coes se~ to be associated .~=h a greater ~~? for ~ater. because 90: of householcs ~:~ wells reported t~eir _ells are dry !~r sc=e period of the year. Jiscance co a year-round -ater source does :atte=, however; tn. farther a household is, the =ore it is ~illing ~~ su?~or: a vil:age ~e:l.  - :5 ­ '.. :r.!"':":~G'!;ESS :':J ?AY. Faa V!l.!....\.GZ '..t :.:. ~r:::'A.'iC::;: a.:m ~'C?!::r-:':-':?"!'3 ::: CI."N '"Ut. :-'~~t,~C::;: ~tural io,a:~t~ ot ~&t~ral loga~~;7~ 0: 'If":'? for v11lt.,. ·. .. n .nnual Qx-~nd!:~rls on OVll . . 11 (:l - :i4) (n - ':'9 an (1) <:) - C:lIlS t.nt -.301 :-liltural leg of household !.:l':oce )j .~j9 .4.56 (4.,53) (l.13) .071S -.082S (.973) ( .... ,548) CrJ:lZlY: Onchoc:er.:!.as!.s .20~ .94.5 (.890) (1.62) .611 2.95 (2.10) (1..58) -. "02 1.64 (-1.72) (l.!4) .5,51 (l.10) -.1:12 (-.:~2) (.1':'0) Oist.nca to year-:ou:d ~te: 'ource _000139 .000191. (:2.35) (.989) :U:::Cy: ~ n.!o! ba -1.!" -2.13 (-~.34) (-2.20) Dw:::c1y: Kiea -.iS3 -1.43 (-3.82) (-2.0i) .ll9  - ~7 ­ !be d~y var:ab:cs !or K!:a ace KenieoG ~~dica:e suo5:a~:ial di!:erences ~ong cercles, differences ~e cannot eX?lai~ ~y :~e :~co~e or ·pr:ce~ variables. As Ilta and K&nieba are farther south aod ~r~bably re~e:~e :ore rain, it is possible t~t the ~ells they have are less ~rone to d=y up for loog periods or easier to utilize. !bough inte~icwer bias is also a ?05s1bili:y, as noted above, the fact that eX?enditures en water (colu:n ~) are also :uch lower in those t~O cereles supports t~e first, rai:!all In general the .~ W4ter results are encouraging- Referring back :0 the validity tests outlined at the end of Section 2, oote that the lnco:e ela3ticity is of reasonable :agnitude and s~ilar to t~~: on ~endi:ure3. (!he education variables are not significantly different :ro= zer~; on :~s we had no prior.) ~d the distance variable, our closest proxy for price, is of the right sign in col~n 1; a vil14ge tubewell .-.~ :rea:~d by reJ'Onden~5 as a potential substitute :or existing shallow wells. :ost of which are private. ~ Finally. oo:e that the a=ouot ot ?ari~:ion eX?lained is ~~c,stantial. ~iven these are household d4ta and c~e s&:ple size is relatively 50411. respectively. and col~n 3 shows :~e expenditure resul:s. ~~eit~er ~~? ~or expenditures are related to !nca:e. 30th, however, and par:~cular:y expenditures en d~gs. are ?ositive2y related to t~e nc=ber of ~ersons w~o h~ve :eeo sic~ in the household in the last year. Ex~endi~:ure but not 4~? :5 70 !nt~r?ret the ~~r!ce· variables on cis:znce a~d cua:i~y r~~u~:es sone explanation of the steps users of the nodern health 5ysten =us: :oi:cw.  - :u - !:C:tU ~t::c.$ &1 ~:t~.:..arr-~ .... t-S4"'"' •• C::'~tl" :.:;'"(.::"1::':...1 ';..:1 ;.&flln(.:"'.I .... ) ~c~r&i :Olac~~:= ~. :.£:*.. :1.';' :'JI.. r~::.:a J! ~ hlr :"• .i.t!l ·"'IIr .... r .&~ .~~:·.. r•• :t1 ~ • JO li&l.Ua e:ra:s.c.s :o<Unt. ¢~. ~.' (:I .(: .11) ) !.!1 '00 ~~a-!=-a.c,ej (~ • 1~1) : ,) 3.:l. ...!O l<&t1.I:::a,l ~"pr:.'!Ia at eo ....... ~~~ :':,f:~ :...:l ·:0~t :"..&~~ ~~Q..C..J .. ;all :~.a) . -.':"31 ~- .:.-~) .:o,,,. .;6;3 (.0'.' ( ~.:! ) -.w...,­ C-."H) .::. .6<!! ( ~.:.') . ~: .:~) -.:%.:! (-.0") (.3U) -.::17 -L .;~) :::-...,. Uc..r. aU.rly ,.:3C& ........ '" I ~ -. ~!7 (.2., ~~ ] ' & " ) ( .. l ~) (-.3J~) . (l.H) ~:) (- ... -.';0350 ::.) .:::t 61 (:.:) ::t.a~ :, ::.&o\:"II'~ ::"'--1 ""CdC -.CC"Jl -.,:n:, -.O~5: (-l.~ .. ) :-3.:" (-l.o~) ~ll:'7 ~J"U&17 21 :.a&nu: !;! -.;J6 (-L.;') -.B' : ... ~. J1) ~u:? =~ :.aansc. .!~, - • .119 <Nut ~-;.·:l ~! ::L.;..~'t"!' "1M ~~ -.~:'1 ., ~:! -L. ;, ~~C . , ~a U:a (-;.;6) <-:.!9l t -:.0:') ~: !".J.u:'oIl. (or ~J:"'.""u) -.:w ~J"u.417 (-l.~" -... -. ~-:.i') -.!!7 -.;~O :-1.~7) t-.;~;~ •• ... n •.:.:..:....t ntS:"llu ...;" ..... ;-.1<\ Oft tx.e:..u:<I::a. ell. ::-a<:.~:~;r... ;' ::.;.'S. ,.~ 'c-.!!:.:..:...c.t. \oIl':'t sa::'.::"~1 a:'r":"!!::.ant, ~ "'t':.a" ·~t!.&~l •• t :':' .. :.1::::. ea i~~r ,~e:.e .=4 ~~ t;r C~Q :;,ae:'~Q :t ~I;.~ry l~ ;;-.;.C ,~::.t, .... ra ,;vo•• a ~:a Ht'II :: ~':'<0:14 : ..... u:;:ec::a4 :.! =><:.en l~ ::'.. ~::.; .... ~ ::-".' "-:'I U :""uc ;&r::...a..:. Rue:.:...:......  - :9 ! r:-egular, !.::.adeq\l.\te a:d rapidly e:e.austed. :5/ ~us ~os:::. l.:.Se:-s ...ould ~eed !~ colu::n 1, - ..h l:::" i:l.clt.:Les :""l.e ;:e:-:les va:.-!ables, ::.e!.:~.er c: :::e ,:'ista~ce variables (:0 disj'ellsary. d::-.lg ou::!.e~) and ::ei::-..er 0: t!:e c,1.:.a.!.,!.::-" ;lrugs (colu::::::t 3) • .uso !.=.cl.uded is a CI'_1 ·.-ariab.!.e for ':':ouseholds :'::1  - ~.: ­ !~: heal:h, :n :er--s o! :~. va11~!:7 :IS:S Quc!:~ecl :~ S.c:!o~:. Sec:nc, ,.  -- - 3t ­ res ponc.e::u:s !.:l. :'owsehold U.!.d. they vO!J.!.':' '::e 'w'1.l!!.:::.g co ;::.11y ! or 'O/e 11 est1cat:as of t:Uit a:tnual c.os:" gover-..:::e:.e !l.o~s :0 cover loc.ally: ;0,000 !'!! !or COt,?!J.ted a.s :!::.e a.verage ;>4: c.6p1ca '.." ,:: tor uc::t houseb.old, .111."1!:aged over hOl.senolc.s .r1:=.!.::. eac.b. cer::le; and i:l :':::.a !.a.st colu.::n aVe. :oaged over: all tle ;ic.ed :0 !!.:..a.:Cl!'. :h.e. 'O/e!.: t:h.an could. :.e a~~u.at:ely se:"7ed 'by it:. ~:;:;r do :he collecti:::n C05:5, :h.e. !!.g-.;.res 1:\ ':ab.'!.= S cve:s:ace :::. degree ::'0 IJhich :h.e.  - J2 ­ or --,- 'l".&b:,e 6: ~!c\7':~!1~ ECCSE1iOt.:J ~,,-:p ',lA ~ '\'\'0 SL\L:"! A..'!Ot:Y:"S FeR 7:!.!.A.GZ T:.'\A,.'\C:;:C ?:to.::: c:s ~~ (1) ~.r capi:~ ~4? !cr 2:-8 89 124 167 -.rater (2) ~u:b.r of ,crsoas ...... ., iS1 !6~ 419 uCluired. :0 :uc:!1 annual mOU!'1 t 0f 10,000 ~ (3) ::~hr ,! Stl~t1 S 9 'f'til.a '<ri:!:1res of to of 38 ~! poVQl&tiou o*low rQV 2 .a:ow:u: ----,-----------------------------------------------------------­ lC2 (4) ":'ar ::apt ~ ."':7 for 90 h... l::t (~) ,ru::b.,r::lt ;:e:so1U ~87 "!..,., I ..... 637 rlqu!:td :~ :ea~~ anrm:al CO-.:ll. I: ot 6~.OCO ~ (6) :luuber ,! S'.l:""l't:r 5 16 'rl.ll.agu '.r!:!: o! lJ o! ;'0 a! 38 ~/ ".XI~l,u:!oc..'S eelow :'ev ~ a:cu::::.t .&/ ':~~is is ::ot ::-.. S~ .lcr:.:u :he 3 cere!u ;ut :~e :u::=«r of -n,.!!ay;t, '..!.:h po?Ul,!ticns below :~. ,opuLa:!oa requ!:e~ := :eel: :~e .ave:age 4~? ~=ou~:.  - 33 SI!C:!.OC 5. cle~~ly be~ter c~n to :~e ~eal:h ~ues:~on -- ~~ ter:s of (~) :~e lO'lo'l!r le.vel of de:.acd. ass .=.in! all vi:lage house:~~lds cocld be assessed. av~rage 0: :;::e ._­ .... : ser'Tice:s !llvi:sico.ed, a~d a ;:::-iori con:s:!'deratio~$ '.;auld ::a'le !ugges:ed ':e:::"  3 .. lavel of d.~nd. cens :.:e:::a:!:rc.5. :a.:l:lO c:: '::e .vo!:!.",!.!.  - J!i ­ from ct.e ?o1:lc of v!.ew of dfic:ienc:y 1:1 t!-:e !-!al!.an ec:ono=y as a ·... hole a::d ::l cer:a cf equity, is a =uch ~or. com?licaced economic que~:lon. On .c~no~c sround~ alone. 1. c ::.y well no t b. jus ti!1ed. However. given admillis craci". and pol.i tical r.ons traint s. chese resul ts suSses:: the pass!. bill C7 tha t local co.t rl:eoviliry could raise wel!are - first by assuring chat soo.e r .cher chAn no s.~,tc. is ?rovided. and second by sec:i:lg ill ?!ace a 'yJ:~ which provides tor so:,e l:leal contral. Thac passibllicy is IIOren a ::'ealiscic: usess::enc in add! tici n&l s\:: tinss.  - 36 ­ Sell ~O!' u:.J.C.ple, :~e elu:, :.h:. Sahel ::QjXJt': Oil th. di!!!.:.-:':"':":!.es ::J: :::e S.1. :l.li.J.o. ;:oulle:,~es of -;'-es: A.!::!ea., !::cluci!:.g :-'..al!. 'l'b.!.s is coe co !.=;lly c:-t.l.: :!.:provcctlCS ill a:fl::ie::.cy .!'e ::0: .1:50 .::1 ui,orcallc opcloo. •. !:l. :..lo.y utt:!o.gs 1. c: is jlrobab.!.7 ,,-:o:::.g :0 ::-u: :::e pcu1bllieiu i:::ic?cdeo.:17. A. g:'!3.ca:' degne of cos: ::ee:overy cou:i auur. graacar af!!d.4ne:y I ?a:-c!e~ ..l !·ly if t't:.::.ds .:'S e;Jllec: :ed J.~:i e:Q 11tro ll.({ at ch• .!.oe:al lavel. :~a 1:.co:. lavel of house::'o1is i:. ::-.. area :)! :-'..a.!.! sc-..:.:.!.&c. is 'II::"! :;:.;; c~, q\:..s:ioll o~ ·Jh.c~ar i : ::.au. a.:!y sa:1se at: .:.11 :0 e:o::::e:lljlb:.a d:a.::6i::g fc:r sc'eial sc:-Tie:u c!t1.l.l canllo: be avoided. Un({oubcad:y. s:.:tll i:~rovc:ellts in etf!c!e:.cy ill urban hospitals or s~l s~fcs !.Il ca:::.:::.l lcver::.ut haal:h a~ecci!.:~e. ==0: urban hOlpi:al c:~r. :0 ~J:al pr!.:.ary h.al~h e4re, ~oul~ ·jlu=::~..as.· :uch greater i:.provteao.cs !.Il overall ~e~.!.:~ status chAo. =e1.atively l:r.r f ••• ..,Mdt are buri.:lSolU :~ floor hou,cho::::s. !: t~.s raper, c~e vi • .., of 60ver~CIle acd docor (i: :~s ;:.1'11 :::e :';0::1:: S,ck; USAID has cakeo. & si:i1.ar ?Os_cion 1~ ~..al!). c~..a: so:.. recovery of c:c.c~ ae the 1::<::.::.1 ':'tvl!. :'s 'lec.:uary, is aku: as:. ,t::;':-:~~IJ ;:o:'~t:; ~. .t..thrl= :!'-..a: ·/~.fJ !os ~uj:!.!!.ed. !'::~ :ha ~(.,;Ii~: of V~8W .,: ove=Ll.: .$!ic:!.~e:1 1~ c~e ~~~ eCO:1o=1 as a ~hol. --- is a :ore co:.pliea:ed ec;otlocic quuciotl and at: teast ;:&:::11 a. ?ol.~:!:al ql.!e.s:io~. ::1 J..:'.y eve::.:, 1:: 1s li~.ly c!-..a:: :!':.. flO!.:::: :.ad. !.o. c!':.. jlrecadi.:::g ;:arag:-aph could ':e 1::por:.a~c:: 1~ :~e long ~":':::t i .•. t:u..: l:::eal !!.:::a:::ee coul:! :.:.lc:i::a.:::a':'y a.ss~t'e g:'s&cer local ,ua.l!:y c~:::::-<.ll, ::-.:::luSh '::1II::~r ac:::e:u :,:, ::ed.ica.l ~1.!'j:tJ.'::'e,., t·:..l «ce:. TI'.!.s j)oi:::.c :eia::::':::g I.'hac: a::e cC'.:."lea:l:..a:::: !.:l?u::s co:::t, :.:? .:._ ~;le CJt::tC b.1cv. 11 ~IC:~ ::.ou dlr:a!led ::O<!e15 of t:he ie::.a::.:! !o:, h~al:~ ~a";'e :u.::: <ie·a':.:;:e:: .3.:-.': clIsce:!. See :Iflllir C.9i~) a::.d A~~:..!.E..' al. C.9S:). 4/ A..:; eua:::'y :he ::'e::.a:ld !o:o "Ja ::e= shoul:: be ::oeated as a :!e::-: ,,:,ec:. ::.e.:....::.:::, ',;!.:~ v!~ter 2.:'1 1..:';"..1: :0 ~eal::tt ~ood COt1su.::~t!~~. :a::"i~g ~::. :0:" :::'e ?c!:::s ::;I.de :': t~ts ;:.1,;:er, :~,e si:.?l!.!ica:':on he=a is ade",l!a:e. 11 C,lrt'e!'lt h.eal:~ se.1,tus o! ":1ouseho1:!s !.:l ::-..!.s sa.::p1e is ::0::: :e!a:ed ?air:1vely co 1.::.eooe, as i: '~uld .t!su::"ed!.y '::e :'.:1 .1 l.a.:oger s4!:?!.e .-:.:~ i::eater t'ange of :':le::-::.e,. ~I.;. i:!.s ::.oe u:u'aasot:..1,::le :,:, c::eat ::or::::':!i::'7 a:s ra!1dc=a. aQd =.0: :,:, "Jo=-=7 a.:ct=.: '!.::e::!.s:":~ o~ c:n.!·=,?:!.~!! 0: "~e.a.:::':." :.:"' el:l!e.:: ;:er!ocis. 6/ ;';:lth.Ju: Juc.h a di!!'ere:::.c:e ::=:·...ee:1 jlr!.va.:e .1,:::d social :.~a::ci. c::'e ::'Ol:: .!fi~!ent ?riee to ena::.e ~ould :e che ~rg!.::al eos:. :~ :he :'.1,s. 0: h'lalth and lola:.:" the :os: obv!olJ.$ ex:er!:..alit1 is c"J.e :0 disease :e:'::; c 1)n1:.gio. l 5. A:1 icd!-rtdtal • ...ho i::.c"J.t's eos:s co sa':eg-..:.1,:-: hi5 own hea':'::.h d~,s noe ca?c"J.re .all :he ~e:::ef!:,; :e:i~:ors :.;ho are !eS5 l!~ely :0 ~c ! llf ec: eld also ball!!f!.:.  - 37 ?J See ~obani (~982) !~r a !ull disc·.lss1cc. cf ::-02 efficiency a::': e~'~:'::" 1::lplicat1ons of ra..:.,ing fees ·...t-.en excess C::.e,=,..and is obse::',ed; ar:d 3!'::!~.1:': (1982) for tr.l1 1::.plica:1oc.s \then excess dl.cand is not obse:-ved. 8/ Clearly the gover..:2nt could i"lcru.sc Ca::'ilnd be :-educing ?rice s:!.:: further to a :'tegat~';e .count, La. a subsldy, :-::a q\a5tictl is Ilt-.e:::e: g~v.r.~ent could afford it. Subsidies ha,~ been provided fJr so:.&! services, cust obviol.!.Sly education, particularly higl'!er educatic~. a;:ci fatUly planru.ng ser-rices (e.g. ?arsons ·.it'.o \mc!e:-go sta:-ilizatiotl are gi·.. e;~ cash or oth£r goods). as~u=p:ion is :~c ::oarg1nal costs are ~it::er n:;'.ng no;:' 9/ As drali'll, ':he f&";'ling. As sar-,rices lilcA! health are ax:ended :0 :ore .lad ::o:e :e::'<:'':2 aress, oarg1".al Cr'S:S could ~ll rise; ..,. bow !turprisingly 11c:le .1bc.lC the path oJ! costs '.lnc!er different circumstances. Ro.... wr at leas: in :::is region of ~.li, substant1.al i::pr:lve::.cnts in qu.ali:y are ?robably ;:'(15s:.:'1e without any 1ncre~!~ in ~rgi~l cost, as discussed :ore in ::-~ text below. ,~ F or a t:lOt'I! c.etalled c!.!..scuss1on, see Birdsall (1582). 121 For a !'uller d1sc'.;ssi·.Jn, see ?rojec: paper ;:repa:ed ':y !-'~r::-..a Ains·...or::-.• ''1'h.. De:nalld for r~al:h and Schooling in !'!ali: :tesults of t:-~ Co=u:l.i::.y ar:d Sa ~1ce Prnvic!e r SurIe y". ,ll! S.e for exa::.ple Free::.ac. (1979). For a discussion of ::-~ apFlicati~n of this method in develo?1n~ countries, see Hitchell (1982). ~ncial:. ?cer.n a:ld Tolley provide a useful su=ary c.! the t::eore tical issu.es and of e:t,er1::en.:s in developed countries. 14 J.:!.. Follai:'\. <ind ::. ':i::.ene: "'::!t:!.::.atiug ::-.e :.e::.a~d !'cr 2cus!.::g Characteristics i:l :.e,,'eloping Cou~t~ies ," ~r';an Oevelo;:::.en~ :.e~ar:::.er:c:. :11::.e:o, 1983 .151 On.e :11ght. ask why :lO ?r1va:e =.a.:k.et e::.erges. ."":-.e alls·...e::' ::.ay '.:.e :::a: :::e:e are external1:!'!s ot· u:r:-lc.et 1::per:ectior..s (po~r ca?1:al ur~e:s). :~ :::e case of lade. of i'ra7ellt1~ haal:h !1llrvices in r".l:-al a.reas (•• g. 1:::::1uni:a:inns). t:-~ !.dea of "u:linfor-;:ed cons~.:lI!!rs" ~=obably also ::as :.e:-i t. ~ Respo~~ellts are ?resu~bly unwilli~g :0 i::cu: :~e costS o! :1:lC!i~g cut tIIore • ill This notion was sllgges:ed;y Sa.::1\Alson (1954). For a :epor~ of a:1 .xper1~nt 1:ldica:i::g f~£&-L1dillg 13 a !a~tor, but ~s a. rela:1ve:: =oces: effect, see Schn~1der and ?occe:ehne (198~). ~r: (1974) also =e~~=:s results of an expe:-l::.en:. 131 See ~.i:chell ar.d Coarsor: (L9S2) !or dlsc'.!ssion.  33 : 91 !:J. a s~~;3ec"ue1:.'C vis!.: ::'.:1 :~es. vil"l.. g!!:!: al-:.cst: -~ v"nurs :a?::?C't:e.:i vtL:.ag~ rs ·.oa::.t:eri co cow .:-.eo. and C~6 1~tallation of ~el1s b4&i~: :s.~. "::-'8 "al!. F.o\.:,s4hold a::.: 3&~~, ~?JJ :c::~c~c!~S). !.:..sca:".!..ac'!.otl '':~5*:S i a:o..1t"\t.!..rg r-a!.:: c~:'! ... ':~. lO-:"':~l1: :';'!e of :::.e .... J.l, :~ ~ ~iS"'H!.. 1:!:.! :::'co'J.'.!l is ~!1::..ad u o! e.a=-:-..cd a::.d u.:::..ea~ed 1:.c:::::e (::'e ~::e:- ::.:-:'e 5~ ~r!~:!...!.1 =-f:!.::~t1Ctl,) III !~;:=OI. is :.!-.. 5t.:: o! ::... ·/a!·~ of C:O? • :"":-....LG ;:11:;oduc.r::1r'l1l) '.;s:i:J.g !J.==i':.t:e t':i~es I of '::~t.:.a:''!'::~d yiel"':' o! 1..!.·:uc:;,c:,:. cle-::.ed <'-Ild 0' inco::. ! rct:l second.a:-! 'I.e!'::'v! ::!.e s. :.!.1:.'.;";s !a:":l !..a ':::ot' CC.S cs. :.e C4\.:,se :.i.lu:h :ro? ?=::<:.~:1on is <!.!.:eC::;!.l;:::::'$~ed. a::.d :::-..e ':a:~il. ?r1e.t; uf :::!..llet:. -:!1.e i'rt: :ira!. c:,op, !.,s : . ...-!.e~ ~~ !a:-::--:a':e ?r:!Ct1, ::'e ,;,o:-:!Ct1 of :.!.::et ~rodu::ic: c~:~~spocd~~g :~ ~~e ~s~~:a~ad hcu5e~~:d :o~s~;e~o: ~s va:~ec a~ :::,.! t'il:ta:!.! ?C''!e.e. 15/ 7he ~ig~ en :~e d!~~~c~ T~:iab:e ~~ c~l~ 2 ~s ~t apposi:e i~ sii~. ~.s i«: :'0: sl;=i':~5i:!bt ~Cl.;e1:.""e:-. ...:e ;;cu.!.:': exyec.: :::.. s!~ C~ :!.!.!:2..:"'.=~ J .... ':.oll.l.l::l. : to :e oppo.s!.:e 1.0. J!.g:l cnl;r !.! ::-avcl o;a '!'e a!s J :E:-::;~!=e<! :0 s;:e=.d ::oney !.~r ''W1.:e:-; i:: !a~: t:-.e Oy?os!:a is :~~, !..e. • • e ..·e:e c'~ y a:1.e :0 a~:!.~l:a :~e e~ecd!.:~:e Qq'~c!.~1l :~: ~ou$ehol~5 4~:h :~~!.= c~~ '~l! !::l~ Jha~ :=a~el ~~s ~o~ &~ !.ss~. lU ~tl a.·./e:-agl!, ~=J.e:a vi~.!..Age.5 &~so 5~;J:-e~ ~'J\"·e= :r c: ::.cce:-::":':Yt .. :1 ~::.~e:,:: ~cc.st:r'Jc::e.d. co. :ne ':as!.s of !1el::".;c:k.e!'s !'I!!:?or!sl. -- 'r..!':'age "::y ':!.ll,age. -- reia~d!.~g :~ :~ of loeal ?ol~:~cal C:~~=4C!.0~ a~d l::eal !.~vo17e=e~~ i::1 thl! C2.!h eeoco::? cut:s!d~ :!':c 7il !.a ge • ~e !.::.Cex ;::as ::.ee.~ssa:!.l;r 'J'e::: ,ub~ec:;,:!.·tt! and i,:s ~e !.:l <i ~g:,e55!.C::1 c::ln:r!:\.:,:ed l!.::le !.:l :;"e '.<1.:' 0: ;:01!.c7 !.::.s!.!;i~, 50 !.: !.$ ::.oC ~ed.. 13/ !:l Cti::o ',i"..a::t\ so-.:a':':ed ':la:e:oee coctors cio :-e:a ':",:a.!..s. a :ae s:::.""..:c:'..::e a.: cj~~cs a~d ~OS?1::'3!.s ~4~ :een set: ~? :~ e::.e.ou=,;e e:ie,,:s :0 go :1:;5: ::.~ b&nfoot: ~oc:.ors; c~.y -;;'1 :!.au at C:A Mspi::al, !or- e:ra::?!..e. ::-.a:' ':-:.a·:e i= bun :-e!er:ed :.r4::' i! ;:oe. See C'.I!tl (1981) a~d ;;a::c,t'd (t98l) ::= :c:e :=. ..... ~:le Si::.""...:c:u:-e ca.~s 1::':0 a.e::'~U:l":. :::'11 higher ;lr!.·..a:s ::..e=.a::.c. :::!:; t:n. '.;:ay :.. c~:a::~7e C:~~?4=~~ co trevq:t~7e ~al:..~ ca:-e. 29/ Fee c:o::ec:.:..on ~s ~.. :a:i.·le':':1 eas? :.':) e~::~<l wi:e:l !ees 'l:e :i!:ee.:':': :':'::~~ ' '=.':) i::,C!.7i':-...:.a!. \lse 0: sa :."":!c:a. ~c\,;e'le'!', sue.:: a~ a??roa.c~ ·..."u.:.d :'tce. ";:p. prac:!.ca':' :o!: :'i.:;.ane..:.::.g of a 'r!.::a.g'!! ',;a::'-:": :':0 U 1;.'. :':..:.el: ':;.e ;::;c::~ :o:;a  39 ­ costly :ha:.'l :~e ~.,"el!. ::.a!:l:er".ace, =equi:"!.:lS t~a: sc:eone :e ;:;a!= :~ :: . ::::.::= use. Sor ~uld lC ?rac:~cal !or f:~anc:~g ~f :~e ~eal:h ~o~~er, :3~: ~: vhose ac::vi::es should ~e preventive, and un~er:akea a: :~e ~~i:!a:!7~ :: ~~a wor~er ~acher ~han of 'the client. :bus so~e sor: o! ~re?a:=en: s~~e=e ml~t be :!.:ple.!'!lented, 1oI'i:~ vir'::ually all village households c:;=?elled. :0 join. tn the household sur/ey, :espoad~n~s were ~sked what ~ode of cos: recovery they prefer=ed: ?4y=ent t~rough the village -toa-, a k:!.od of village club Jr :ouacil, ~hose :e=bers are gen~ral:y young (13 to JS years) and ~10 hire out th~ir labor to individuals for ?&:~!ot in kind; fixed ?:e~a:=en:s ~y ~o~seholds: or fees for Jo:v:!.ce. ?ay:ca:s through the -:0::- ~e~e ?reter=~d in :ost Villages. :be d~ftic'~:7 is that the ton, have vir'tuall)" ::0 e:t'?erieoce 1::1 hanclli:.g c:un f .... ::lds, and the cne or :'."0 ::.-peg of organi%~tioQs :hac do ha~dle cash--pa:ent ossociaciocs assoc~at!d ~i:h schools, a~i local branches of the ~olicica: ;a:ty--vere con::ollel outside :he ~illage and accQrding 'to villagers, suffered =is=anage:e~t acd ,:orrupcioa.  - .:.:; ­ Ai::lsyo:-th, :-'.ar-:!'l.a. "7!:.Q ;)e:uo:::.d !o:: Ee&J.th a:-.d Sc~ool!.:::g in :-'.al.!: ?~su::s of the Coc::un1:y ... :::.d $.e:-"ic", ?!'::vi~er SU:-/ey." ''';cr:d 3a,.k., c.:n::.:::::-y Policy Oe.,a.:--:::Att:.t dra!t, :e bl:".J.a=7 i 983. Akin, John S., <::::harlas C. Gri!!e\n; :.avid K. wi:~1 ...nd 3.a.:--::" !-!. :£lop;';'.!.:::. "~ .. t'c::.acd :or ?!'!.::aq E.e.a.lth u:-e Ser-rices i:l the Sicol R.eg!.:.::n c: the ?hil.!.?pi.::..s. " Papa:- ;:::eseo.ud a: ;iC:a Coo..!t!::'enc. on H:-.a.cC.!.:::'3 2aal:h S~r7i~.s ~~ :'ve~c?1:g C~un::~e5, A4Sh1=gCOQ, J.C., ~=a::, ':ll:l& 1982. 31::,dsaU, ~:a.nC:7' "Sc:::a:egiu !cr .'.ll.aly:!.:::g Z!:ec:s of ';]S4:" C"l.ari.s !..." :~e Soc.!..al Sec:ors. 1t '';orld !.&:::.it. Wll:l:=7 Pol;:'cy Det:a:::::.a.:::.: ri::a!':, :ul? 1982. 3r~ok$hi:: • • Cavid S., :-'.a=~ A. ~1:J.i ...: ~. Sc~ul:e ...nd 3al?h C. Ar;e. ~yer, "V~:'~::.g ?ul:>l!.c: c.oods: A WCl?U'!.son 0: Sur-Ie? ... nd Se':o:::.!c Ai'proac:!'tes". A::.erte.an ::conoc.ic ?~vi~u i2:: (~,:u:ch 198:n. ;:il. 15;­ 177. C':':en, ?i-C-.ao. ?opu:.a:ion a:1d 3i::-:h ?:"a:::-.!::.g i:l t~e ::.0111.' S :.t?ubJ.:!.:. .:J= C'...1~. ?'oe\\la.:!~c. ?..e~c~~s (':Oh!':.5 HOi'~!.:ls ?~;ulz.:.!.cn), :a:t:.a::J ­ :ebl:".J.a:-/ 1~a2. Cl:Jb ;11J. Sahel, C:!.SS (Co:.!.:. ~::-...a~:l: :::.t.e:--:::ats c.e :'ut.:e C-:nt::e :.a. Sec!le:'1!sse ::ia.::"1 ~e S.. r.el), ·";ork.!:.g G:::uj:l O':l. kc~::e':l.: C.:a::!. N!c~r:'1!:lC WS:S 0: :e'n!lC~:lt ~:':::::1=S !.:'I :!~e Cc1J.::.:::'!.es 0: :::e Sahel. AJ:'.a.l.;1!:'s anci :<..ac:l=encia::.~n~. Ou.agad.ougou, Cct.:lo.e::. ~'oO. t~~le Saeion.a!..:! de ~d!~!=.e e~ :.!l! ~...a==...c!.e ct!~l.!.. "::va:!.c..a:.~oc. Sa:-"":":a!.:-e does Ca r:::!as ~ ?7! ~e:a t ~':'Ju!a.c.e. ~:a.: ? ?'P<J':': ?:,e::!..::.:'~..a~:a. '. :e :'1:"..1.:'1.=7. 1982. Foll.ai!1, J .3.. and !. :!...:... < ·'!s:!.:.a:i:::'i :~e :e:.a::.d !o't' ::..ousi~i • "{ ~~::ac:e=is:!~s t!velo;!.:lg Co\;n:=:'es, 'f :::-':00. :e..e':o~:e:'". : _~ 'Oe;>a::-:::.e::.:, :::"::eo. .983. F!'2.e:a!l, A ~!:!<. :::. ~e ~ce.f!.:s of ~~1,1:!.=O~::e~t:31 ?-:~tac:!.~n. !a:=:'===~: :-!C.: ':olt:!.S ao;::i<!:'..S :;:l.!.'le=s:':? ?=ess. l1'73. :ree:.a.:, A, ~,:'!.ck :::r. "A??r:a.c.!-..e.s::l ~.aasu::!::.g :-Jo:!e. Gcoc!s :e:..a~~s, " A.::i!t'ic:an Jcu:-:-:.a!. of A~::,!.c\..:...:.=a~ :::::cnc::.!cs 51,5 (:.ece=~=, :379), n. 915-920. Gra1, C:..!.7e and. A::.d.:II' :'.a=:er.s. "7!:.e ?ol.!.:i.cal E:conc::IY of :.he ''R.eC'.l=-:-e ::'.: :.:s: :-:00111:1' !.~ :~e ·'II"es~ ;'.!:!c.a~ Sa::el." !"'.:!:e.o, -':anu.a:: 198:. N..:.r:, !-i..or~e:a;!.J "'!~t;e:!.:e~:al .~?=::.aC.:: :~ -:.~e. :e:i!:-::.!~..a:ion:: ::'e A=:,,1.~':' - ... ­ ?t..1blic Goocis.'· :cur..a::' 0: ?-.::.':l:".!.,:: ::.::~nc:i..i:::s 3 C:97':') , n. ::9-3':'~.  - :'1 ­ ~..ale :-, Ka r l-Gora c. ".\ ~o ea on :::..e ~se of ?rope r:1 Val..:.!!! !.::. Est::':::a. :!.~5 :-'.ari1::.al ·...illlngne!,s :0 ?ay for E::.viroc:e:l::al Qu.ali ty." JOI.::":'.a:" ~: Environ:ectal Econooics a~ ~r.aqecene 4, (1977), pp. 355-369. ~tch.ll, Robert: C. "A :';ote on t:-.e Us.t of the Conti::.ge:::.t Valuation A?proac!"i to Value P-.lblic 5eT:Vi,;e s l:l Deve lopi::.g ~ia :i005 ." D:-af e, Ace::.be:, 1982. X:!. r:.che 11 , Rober:. and Richard 7. c.:'son. An Ex-:le::i:ent in De:et"::i::!.::s:: ~illi~s:::.ess:0 ?ay !o:, S~:1onal ~ater Qualiey !:orove::.en:s, washi::.gton D.C.: Resources for r:.~ tutu:-e, 1981. Ranc.all, A.la.c, Jchn R.oehn, and G.!o:,ge S. Tolley. ":'he Sc:-uctu:,e of Cotl':i:lgent ~.ark.ees: So::e 3.esul:,s of a Racect E.x?eri:::lent. " ::iraf::. 1982. Sa::u.elson. ?aui. "7he ?ure -::heory of Public Ex;>ec.d!:ure." Revle'J of Econc~cs and Staeist1cs J6 (~ove::.ber, 19S4), ?P 381-89. Schneider. :. and w.~. ?c==erehce, '7ree Rid1::.g a:ld Co1lec::ive Action: .~~ txperi::l.ellC 1::. ?ublic Xic:'.:ec"lcooics". Quarterly Jou:":'.al of ~conooics, Sove::.ber 1981, 4, ?p. 689-704. ~:oba:u, :'.a:een. "'Efficiency a':l.d Equity !::lpliCllCio:s of User Charges 1:l 50cL::.1 Sec:o:- 5el:'Vice!!: ~.e :!.nancing of '!ducatioc. 1:\ :-<.ala..-t," :.::::.::! !3.ank. d:,ai::, :-!.a.y 1962, t.:a.r:Jrd, :e:-e:lY, ff:i::.a:lc!~g Ru.=a.!.. ~alth Ca.re., (Ch!::.a~." ~orld 7'~~"'.J d:-af:, 1982.  - ¥:! - A Household ~:and ~~de~ 0) (Z) _ Zi:". • Zi t, 0: h' V,:..: ) t..It,>-"",,­ ... --­ _ ::ark.et:. cond~:ions :~e co=u::!.:? • (?.) '.:h~:a :;!':.e :a.:.i:7 1.:0 .. :t'S!;!U •  - :"3 ... R -'-1. • Z... L a &(. "'"':'... • .1 .. ' ..... •.... ~ 5) t."T" ","" _,"" a, .... 1 ... "" , &S I.lIIll as e::l.c.s i:l ::-.e::.selves; c'.l:i:,.g 0: :..!.sease !.::creases j>or:e:1.::a': (6) reLat.ions ~:lbedc.ec. !.~ (Z), (3), a=.d (4) a~d (5) a:1.d the bud;!: c~cs::a!.:1.t. (I)). :he c.e::ac.d :·.;::::::'ons ':.Ii.!l ':e ex?t'essed !,::l :e:-:s of t.:-.e exogenous ';<ar':'ables, '.=.c':;.;.c.!.::g ::-:e ?r1ces 0: .11': goods, ~ges, a:::.d :::e ?t'ecie:e:-::.':':-:ed. ;ar!ables !;';'C:I. 3.S ;oc:: :"..3.01.t.5 a::d ac(.;ess :0 .... a:il'r.  - ...... I' ­ :a:.1 ::..edon.1c. :-ent eCtat!.::::n ~I An e~uat!on ~c.h AS the !ollc~~~ is est!:aced: it • f(V' ,?) lIar-ric.es. and. ? !.S an oO!Ul:"'r.\ble :easure of (!o~ e:a:jlle) t~ ':e ~:I!e of a < • pol'::'uticn '.n-..e:1! t!::J! :-es!.,;!e::.ce is located. ?espccC:e::.ts!.:l sa:?i..ad :'ousehc':'':s a tes: 0: An equa:!.oc SI.lc:h as t!::e :ollc~"1::g ::'s cs:::':a:ed: :t 'I. !('l', Z) 11 3rooic...sit1:e .t. a!.. (~9S:) t!:::d. c.o:".s!.C:e:'able :.:::s:!.s!:a:::c.y ':e:·.'u::, :cs\,!,"::':s ot !1edon.1c an.a!.:;sTs--;::d (197i). con:!.:::ge::t .,a':'·.:.at!on. ::'C' a d:!.sse:::.c:!.:::g ''':'elo'' se~ .,.a.:~:  - :'3 - Yh.~. V represents t~e vi~itation rate in ter:s of visi:or days ?e~ o3?ica tj a recreational sHe !~0'C1 a particular l:or.e of origi::'!, based on sur...eys of visitors and using ?opulation data for concentric circular zones; : re?resents the travel cost freo each :ooe j and Z is it. ','1!c:or of o!:~e::, ::one-sj:ecific variables such as average incoce, education etc. !he obse~ed total visitation for t~e site f:oo all travel cost %ones re?nsents or.. ?oint on th.a .:.e::.and C'.lt""-re for th.a.t sie::e. i.e. the inte rse etion of oe t:".!e .:.e::.and cut""... IJi th the horizoncal ?r-i ce li=-e (:or.e::,e ?rice is the adoiss10n fe~1 or :e:o if there is co fee). Other ?oi~:s en :he curve are found by a..ss\J.:Ung 'nsi:ors 101111 ::'espond to fee increases as :~ey yould to equivalent i~craases 1::'1 travel costs. :nere should ~ d1!!e::'!nces i~ stated ~~? as a function of travel cost zones, 'J1:h ~~ a=ounts equivale::'lt to aSS'Ull:eG fees.  :'6 ­ Variable :.!~:i:1on!. ~ea~s a~d Standa:~ :eviat!::s (rables ~ a~d 5 i~ text) :·:.a1:2 s.:;. ~eD~ndene var!~bles: .... 11 b -00 of ~lia'Q !:ancs . ~ac:ural 10;1 ....'1'? • !'iacurd lOll .~s. ·J.U i:1 -:0 of ::-r ..... l!an francs J.CO !"iaeurd lOlr ~-:? h....,l::h ill -00 of ~al!a:l f-::-a::.:s 1.85 LC4 ~acural lOG .=?s. d~~gs ~:1 -co of ~1!~ !:a.nes 2.55 1.51 ~.6.e.r=in.d ~ariables: :lacura.!. log household inco:., 7.i.. col. 1 8.61 Yaeural log household 1:co:.. ~4t c~l. 2 8.!'!. ~acural log household inco:e, 75 8.62 ~u:b.r ot literate adul:s .458 ~u:b.r of ~.rsolls ~:l. school 1. 2.3 ~y: Oneterc.rcias!s al .146 .354 Ou::::.:Iy: Cui:::. u. 110 ~ a I .0760 .:!6 Oul::::ty: t."rosyal .OS85 .235 ~y: S:ocach ~la.d!es &1 .:l86 .':'3a ~u==y: Other s1c~ess a/­ • :'80 ,~C~ ~y: Sic~ bab~ (C-3 Yea.rs) bl .1iO Juc:y: Sic~ child (~~4 7.ars) ~I .1:!0 ~um:y: Sick adult (13-30 1.a:s)--~1 .!7~ juc:y: S!ck e1:.:,ly ~e=son (~ 50--ycars) bl .217 ju==y: ~ell in ccc?ou:d .25, j1s::ance to year ::u:d ~a:er sou:ce i : :e:ers 357 :':90 jiseance :0 nearest ~!s?~nsa:7 in :~lc=.:ars • ;.,. ...... I , 1:'.! Jis:ance eo nearest d~Jg ou:!.e: != ~lo:.:.:s 39 •.3 31.5 ~l!:y of ~earesc dispensary ~ . 5~: ~alit'7 of ::ea:ue d~..!g outlet c.! 2.41 .733 :>u=y: '!)!.1I;lensa.=: and :!::'"'..!S Qu'.:!e: a: ::l=on si:e .537 .!v ~y: ~ss!on (,;,ri"aee) dis;:en!!!a:: .170 .37" ~y: le=!~oa ~e=:!e e/ .!e4-? 'u::y: ~:a cer:::.!e tl .190 :1/ ,1,;lplies:'': a:l1 ~ouse~o!'d =.a:bc:, ·...as :epor:ee: :0 ~ve had ..,41:::';:'.:.':'.1:- ::a':'a.:.:, :~ri~g :he year ~r!or :0 :~e survey. ~II Applin 1! ~ouscho!.:.:l :t:.ber in rar':ic'Jl.ar age :a~ge "'&5 sick a: an] :i::e .~ t~e ~rev!ous yea:,_ <:/ This qual1:1 i::c:!e:t ..u conse:-J.c:ed 01'1 the bu!s of :1.:1:e: and:rai::!~g 0: i~eal:h i'ersoe.::e.l a: d!s;:e:uar!u - a 7<111.:.1 of J !.::.d!.catu the ~=esence 0: a l!oe:or or a c":'ai::.ed :.:.n!7e:si:7 nurse a: :~. disrerula::-: 1 i:::.d!caees i':,ese:o:ce (It 2 or :lon c,ual!!!ed ::eL.:h s:a':!; and ~ !.::dic:.a:as i're:!:4nce of :us :!':a:: : heal:h :!:eat!. cil ~!s l:!ua:!:7 !.~:e:t .... a:. ;:~:-:.s::-Jc:e:: v. :::~e ':.u!!'I ::;: a'/a!la'::!l.!::.> :I: '::=''':~s :ic: :!':e J:-~g OU.::ll!:!. ~:.J S!.~s, :agr.! :'.ldes a::.c! s!.;r::!!!.ea::c. of va:1a~lu a:'e si:::!.!.ar ·..i:hou: :he .! .:u:::y var!a~l.s !or :<..a::.!e:.. .1nci it!.:.. cer:::.1u. ~!! ":'he b<a.se eac!!go:'7 1s !a!ou!.,,~e ell-::-c:.1e.