Assessing Household Willingness and Ability to Pay for Formal Residential Care for the Elderly at the La Nkwantanang-Madina Municipality

Abstract

Background: As populations age globally, there is a growing demand for formal residential care for the elderly i.e. persons aged 65 and above. However, in many low- and middle-income countries, such care is often inaccessible or unaffordable. In Ghana, little is known about households' willingness and ability to pay for formal residential care for the elderly. Objective: The objective of this study is to determine the households' willingness and ability to pay for formal residential care for the elderly in the La Nkwantanang-Madina Municipality of Ghana. Methods: A cross-sectional quantitative research design was employed to gather and analyze data from 460 households across three sub-districts of La Nkwantanang. The study used a multistage sampling design, combining purposive, stratified and random sampling techniques. A questionnaire was designed to obtain information on socio-economic, demographic, and health characteristics of the elderly, as well as their knowledge and perception of formal residential care homes and willingness to pay for such services. To determine the proportion of people willing to pay, the calculation involved determining the percentage of study participants who expressed WTP. Multiple logistic regression was employed to identify factors influencing households’ willingness and ability to pay. Data were analyzed using STATA 17 version, and results were presented using tables and graphs. Results: The study found that 28.5% had heard of formal residential care homes for the elderly in Ghana. About 72% of households indicated their willingness to pay for formal residential care for the elderly, with an average amount of Gh¢1,403.30 per month (minimum GH¢300, maximum Gh¢3,000.00). The highest percentage (38.9%) of households stated their ability to pay between Gh¢700 - Gh¢999 per month, while the lowest percentage (1.52%) between Gh¢300 - Gh¢499 per month. Multiple logistic regression analysis revealed that age of household head (OR=1.26, p=0.01), household income (OR=1.62, p income households are more likely to be restricted to lower payment levels. This was demonstrated by the fact that the highest percentage of households stating ability to pay over GHS 1,000 per month are in the highest income group (5000+), while the lowest percentage of households able to pay over GHS 1,000 per month are in the lowest income group (600-999).