Survey Report on the Willingness to Pay for the Usaid Socially Marketed Pilplan Plus, Injectaplan and Protector Condom

USAID-Communication for Healthy Communities

SURVEY REPORT ON THE WILLINGNESS TO PAY FOR THE USAID SOCIALLY MARKETED PILPLAN PLUS, INJECTAPLAN AND PROTECTOR CONDOM

June 2020

TABLE OF CONTENTS LIST OF TABLES ...... Error! Bookmark not defined. LIST OF FIGURES ...... Error! Bookmark not defined. ACRONYMS ...... Error! Bookmark not defined. ACKNOWLEDGEMENTS ...... iError! Bookmark not defined. EXECUTIVE SUMMARY ...... Error! Bookmark not defined. 1.0 INTRODUCTION ...... Error! Bookmark not defined. 2.0 OBJECTIVES, DESIGN, AND METHODS ...... 2 2.1 Objectives ...... 2 2.2 Design ...... 2 2.2 Eligibility Criteria For Selecting Participants...... 3 2.3 Methods ...... 3 2.5 Ethical Considerations ...... 4 3.0 LITERATURE ON WILLINGNESS TO PAY FOR THE THREE COMMODITIES Error! Bookmark not defined. 4.0 RESULTS ...... 6 4.1 Eligible Participants ...... Error! Bookmark not defined. 4.2 Social Demographic Characteristics Of The Participants ...... Error! Bookmark not defined. 4.3 Findings By Survey Objectives ...... Error! Bookmark not defined. 4.3.1 The Range Of Acceptable Prices For Protector Condom, Injectaplan, And Pilplan Plus ...... Error! Bookmark not defined. 4.3.2 The Associations Between Price, Quality And Preference That Influence Willingness To Pay ... 15 4.3.3 Research Questions To Inform More Systematic And Rigorous Investigations . Error! Bookmark not defined. 4.3.4 Challenges Faced During Field Data Collection ...... Error! Bookmark not defined. 4.3.5 Limitations Of The Survey ...... Error! Bookmark not defined. 5.0 IMPLICATIONS FOR PROGRAMMING ...... Error! Bookmark not defined. 6. CONCLUSION ...... Error! Bookmark not defined. 7.0 APPENDIX : INDIVIDUAL CUSTOMER QUESTIONNAIRE Error! Bookmark not defined. 8.0 REFERENCES ...... Error! Bookmark not defined.

List of Tables

Table 1: Eligible Participants by Wealth Quintile ...... 6 Table 2: Social Demographic Characteristics of The Participants ...... 7 Table 3: Table showing prices at which customers would consider Protector Condoms to be too expensive, too cheap, starting to get expensive and a bargain-great buy for the money ...... 9 Table 4: Table showing prices at which customers would consider Injectaplan to be too expensive, too cheap, starting to get expensive and a bargain-great buy for the money ...... 11 Table 5: Table showing prices at which customers would consider Pilplan Plus to be too expensive, too cheap, starting to get expensive and a bargain-great buy for the money ...... 14 Table 6: Participants’ Awareness and Knowledge Of Protector Condom...... 15 Table 7: Statements indicating participants’ attitudes towards Protector Condoms ...... 16 Table 8: Participants’ awareness and knowledge of Injectaplan ...... 17 Table 9: Statements indicating participants’ attitudes towards Injectaplan ...... 17 Table 10: Participants’ Awareness and Knowledge Of Pilplan Plus ...... 18 Table 11: Statements indicating participants’ attitudes towards Pilplan Plus ...... 19

List of Figures

Figure 1: An Illustration of The Sampled Districts and Respective Sub-Counties Visited ...... 3 Figure 2: Current price that participants bought protector condoms ...... 8 Figure 3: Range of acceptable prices for Protector Condom ...... 10 Figure 4: Current price that participants bought Injectaplan ...... 100 Figure 5: Range of Acceptable Prices For Injectaplan ...... 12 Figure 6: Current price that participants bought Pilplan Plus ...... 12 Figure 7: Range of Acceptable Prices For Pilplan Plus ...... 14

Acronyms

CHC Communication for Healthy communities CSV Comma-Separated Values ODK Open Data Kit RRP Recommended Retail Price SPSS Statistical Package for the Social Sciences UDHS Uganda Demographic Health Survey UGX Ugandan Shillings USAID United States Agency for International Development WQ Wealth Quintile WTP Willingness to Pay

Acknowledgements

USAID/Communication for Healthy Communities (CHC) project acknowledges the support of the Government of Uganda through the Ministry of Health/Health Promotion, Education and Communication department, that provided approval and an introductory letter to conduct the Willingness to Pay survey in the selected districts and communities. The various District Health Teams including the District Health Officer, District Health Educator, and District Assistant Drug Inspector, and the Village Health Teams, who supported the district and community entry processes, and selection of survey sites. The identified research assistants supported the field data collection exercise, with support from the community members/participants/customers, who provided valuable views/opinions to the willingness to pay survey for the USAID socially marketed family planning products. The CHC staff that included Billy William Malavu; Leonard Bufumbo; Richard Kanakulya; Musa Kimbowa; Felix Manano; Richard Ssemujju; Rose Namawejje and Judith Nalukwago had an invaluable contribution to the survey design, coordination and field supervision of the exercise, data analysis and report writing. Strategic leadership and technical oversight were provided by Sheila Marunga Coutinho the Chief of Party; Sam Tukei, the Deputy Chief of Party; Edith Nantongo the Senior Technical Advisor and Brian Pedersen the HQ Technical Advisor.

Executive Summary

Uganda has a high total fertility rate of 5.4 children per woman and teenage pregnancy of 25% for women aged 15-19, but with limited access to family planning/contraceptive services to control the birth rate (UDHS, 2016). To contribute to the Total Market Approach, the USAID Communication for Healthy communities (CHC) project was in December 2018 awarded additional funds to implement social marketing of the three USAID branded family planning commodities as a sub-program under the overall CHC project. The CHC social marketing activities aimed to increase availability and access to family planning, HIV prevention, Malaria, Maternal and Child health services, through improving availability of socially marketed commodities and services among target populace. CHC was expected to engage and ensure that all sectors (public, private and private-not-for-profit) are integrated within one “market” that is segmented by willingness to pay. CHC thus conducted a Willingness to Pay for survey (WTP) aimed to inform future programming to understand the ideal consumer price point for three USAID socially marketed products – Protector Condoms, Injectaplan, and Pilplan Plus.

The survey was conducted in eight purposively sampled districts of Mukono, Sembabule, Dokolo, Kisoro, Kasese, Kyenjojo, Mbale, Buyende. The findings show that most of the survey participants were in wealth quintile two and three which were deemed financially able to pay for the commercially available products at various retail outlets, with the majority being women. The range of acceptable prices for Protector Condoms is UGX 750/= lowest and UGX 1800/= highest, for Injectaplan the lowest is UGX 1500/= and highest is UGX 5000/=, and Pilplan Plus the lowest is UGX 1300/= and highest is UGX 4550/=.

This survey confirmed that both contacted men and women were willing to pay for the three USAID socially marketed products – Protector Condoms, Injectaplan, and Pilplan Plus, provided by the private retail outlets. However, key to note is that the price range they were willing to pay for the three products significantly varied. Thus, the results of this survey should be used to inform the recommended consumer price and market pricing strategy for the three products.

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1.0 Introduction

Uganda has over the years seen a rapid growth in population, now estimated at 42 million people. The country has a high total fertility rate of 5.4 children per woman and teenage pregnancy of 25% for women aged 15-19, but with limited access to family planning/contraceptive services to control the birth rate (UDHS, 2016). Although the government has put effort in providing family planning services in the public health facilities, they have been overwhelmed in meeting the ever-increasing demand of the growing population in the country. Hence, the Government of Uganda sought strategies to re-balance the market by reducing distribution of free family planning services, which would create space to grow the socially marketed and commercial product sectors (Jones & Kadirov, 2017). Some of the strategies include establishing a platform to engage all market actors, funding research to effectively guide market segmentation and monitor performance and building the capacity of stakeholders to understand and apply the Total Market Approach concepts.

To contribute to the Total Market Approach, the USAID Communication for Healthy communities (CHC) project was in December 2018 awarded additional funds to implement the social marketing of USAID family planning commodities as a sub-program under the overall CHC project. The CHC social marketing activities aimed to increase availability and access to family planning, HIV prevention, Malaria, Maternal and Child health services, through improving availability of socially marketed commodities and services among target populations in Uganda. CHC was expected to engage and ensure that all sectors (public, private and private-not-for-profit) are integrated within one “market” that is segmented by willingness to pay. Thus, CHC works in collaboration with the ministry of health, district health teams, private sector providers, and community leaders to provide health products and services to last mile users who are in wealth quintiles 2 and 3 and predominantly women, especially young. The services include the distribution and marketing of three USAID branded commodities – Protector Condom, Injectaplan, and Pilplan Plus.

As the CHC project comes to an end, it is important that the contribution of social marketing approaches within the health service delivery space, are documented through assessing whether the consumers are willing to pay for the three USAID supported socially marketed products. This will inform USAID’s future decisions on social marketing interventions in Uganda. Social Marketing assumes that customers shall value the product they spend upon. Customers are assumed to be having the ability to pay for the products. What is numerically unknown is whether there is any indication of amount that customers are willing to pay, holding other personal expenditures constant. Therefore, there was a need for the willingness to pay assessment to inform USAID’s transition plan from free provision to socially marketing injectables, Pilplan Plus and Protector condom.

2.0 Objectives, Design, and Methods

2.1 Objectives CHC conducted this survey to understand consumers’ willingness to pay for the three USAID supported socially marketed products, as part of its routine monitoring research in March 2020. The survey objectives were to: 1. Determine the acceptable price range (lowest and highest monetary price) for Protector condom, Injectaplan, and Pilplan Plus 2. Explore hypothetical associations between price, quality, and preference that influence willingness to pay. 3. Generate research questions that can be used to inform more systematic and rigorous investigations of the qualitative context of ranges of different prices.

2.2 Design We used the monitoring research approach to implement this WTP survey. Multi-stage sampling was done at the region level to select the survey districts of; Mukono, Sembabule, Dokolo, Kisoro, Kasese, Kyenjojo, Mbale, Buyende. The districts were purposively selected based on eight components that made the sampling criteria, including: (1) fitting under the second and third wealth quintile; (2) high total fertility rate especially amongst adolescents; (3) high HIV prevalence; (4) special areas, such as mountains and islands; (5) boundaries along refugee camps; (6) UBOS sample districts; (7) licensed drug shops in USAID/FHI360 APC project districts; and, (8) residence (rural and peri-urban). Within the districts, cluster sampling was applied to identify sub counties in which data was collected. These were clustered in each of the eight districts and randomly selected 50% of the total number using the RAND function in Microsoft Excel, e.g. [=INDEX ($A$2:$A$16, RANDBETWEEN(2, 16))]. Drug shops and private facilities were further clustered by sub county so that at least three facilities in each were purposively selected and interviews conducted with exit customers. An eligibility criterion was set for selecting participants. Figure 1 on the next page illustrates the sampled districts per region and the sub-counties visited. It also shows the total number of private outlets visited.

Figure 1: An Illustration of The Sampled Districts and Respective Sub-Counties Visited Uganda

Central Eastern East Central Western Northern South Western Region Region Region Region Region Region Mukono Sembabule Mbale Buyende Kyenjojo Kasese Dokolo Kisoro District District District District District District District District

Sub-county Sub-county Sub-county Sub-county 1.Mpunge 1.Sembabule Sub-county Sub-county Sub-county Sub-county 1.Adeknino 1.Kasese central. 2.Mpata Town Council 1.Kagulu 1.Kisoro Municipal 2.Bata 1.Bungokho 1.Butunduzi T/C 2.Nyamwamba. 3.Kyampisi 2.Lwebitakuli 2.Buyende TC council 3.Kangai 2.Northern Division 2.Kigoyera S/C 3.Kichwamba. 4.Nabbale 3.Matete 3.Kidera 2.Muramba 3.Nakaloke 3.Kyenjojo T/C 4.Hima. 5.Kimenyedde 4.Lugusulu 4.Buyende 3.Chahi/Kyanika 4.Bufumbo 4.Kyakatwire T/C 5.Kinyamaseke 6.Goma 4.Rubuguri T/C 5.Nyondo 5.Kyarusozi T/C 6.Katwe kabatoro 25 outlets 7.Mukono- 6.Kanyegaramire visited Central 6.Bubyangu 7.Mpondwe 7.Busiyu S/C 8.Kyarumba 16 outlets 8.Mbale Industrial 19 outlets 7.Kihuura S/C 9.Kisinga 17 outlets visited 9.Busoba visited 8.Katooke S/C 10.Kasenyi visited 61 10.Namasaba 11.Katunguru respondents 36 outlets interviewed visited 132 98 82 respondents respondents respondents interviewed interviewed 27 outlets interviewed 69 outlets visited 130 47 outlets visited respondents visited interviewed 155 163 respondents 131 respondents interviewed respondents interviewed interviewed

2.3 Eligibility criteria for selecting participants A participant was eligible if they were determined to be of wealth quintile two or three. Using the DHS wealth index construction (https://www.dhsprogram.com/topics/wealth-index/Wealth-Index-Construction.cfm), the participants were asked about having selected household items, and their ownership. Responses were used to classify respondents into one of four categories, including: 1 to 5 for wealth quintile 1 – which was deemed for free products at public facilities; 6 to 10 for wealth quintile two, and 11 to 15 for wealth quintile three – both of which were deemed financially able to access commercially available products at various sources; and 16 to 20 for wealth quintile four – which was deemed financially stable beyond quintile 2 and 3. For this survey, only respondents who fell under wealth quintiles two and three were eligible for participation. Figure 1 above also shows the total number of respondents interviewed in the sampled districts.

2.4 Methods Data collection was done using a semi-structured questionnaire in which the price questions were based on the Van Westendorp model (P. H van Westendorp, 1976). Interviews with exit customers of the retail outlets were conducted. Mobile data collection through Open Data Kit (ODK) was used to enable real-time data capture and submission to the server for cleaning and analysis. Data cleaning was done before the records were finalized and sent to the server, and at the end of the data collection exercise where a CSV file containing all the data was downloaded, cleaned and an analysis dataset created. Analysis was done using SPSS and MS Excel, following the survey objectives. 3

2.5 Ethical considerations This survey was conducted as a monitoring research activity following ethical considerations for the participants. Participation in the survey was voluntary and an informed verbal consent was sought before interviewing the respondent. Records were made anonymous with no identifiers to trace back the respondent.

3.0 Literature on willingness to pay for the three commodities

With the increasing demand for contraceptives among men and women globally, there is growing recognition of the need to engage the private sector in national efforts to achieve contraceptive security. This is because the private sector has the potential to complement public sector efforts by providing additional resources and help in responding to growing market demand (Hardee et al. 2017; Sharma & Dayaratna, 2005). However, little information exists about willingness to pay for contraceptives such as Injectaplan, Pilplan Plus, and Protector Condoms provided by the private sector in Uganda. Available evidence points to various determinants of willingness to pay, including social economic status and free services provided by the public sector. Evans et al. (2019) concluded about the effect of continued availability of free condoms and financial ability to pay on willingness to pay for condoms in Kenya and Zimbabwe. Onwujekwe O. (2013) state that willingness to pay for modern contraceptives varied across social economic status in Nigeria. In Ethiopia, education, sexual activity, and employment determined willingness to pay for injectable contraceptives (Prata N. 2013). Nalwadda et al. (2016) note that high and varied consultation costs, commodities, and other services prevent obtaining services from private providers. The above studies show that populations who have been exposed to public free commodities, those who are using free commodities, and those who wish to use public free commodities are willing to pay depending on variations in social economic status.

Limited literature exists about the assessment of reliability and validity in the questions about willingness to pay, though authors agree on methodology for determining prices. Willingness to pay is defined as the maximum price at or below which a consumer will definitely buy one unit of a product (Evans et al. 2019; Foreit 2003). Emphasis is on comparing a range of prices and point prices. The range of prices when combined with maximum price measurement elicited reliable and valid prices in Pakistan, Mali, Guatemala and Ecuador (Foreit J. 2003). Braun C. (2016), found that open-ended elicitation improved measurement substantially. The range of prices takes care of the human element of dynamism in preference.

Against the above background, the current survey assessed the consumers’ willingness to pay for three socially marketed products – Injectaplan, Pilplan Plus, and Protector Condoms provided by the private sector in Uganda. We sought to measure willingness to pay using Westendorp model questions, open ended questions on high and low prices, followed by open ended questions to elicit maximum willingness to pay for Injectaplan, Pilplan Plus, and Protector Condoms.

4.0 Results

4.1 Eligible participants Based on the eligibility criteria, a total of 947 respondents were contacted and interviewed, and the majority 83% (n=787) of the participants interviewed fell in wealth quintile two, while 17% (n=160) were in wealth quintile three as indicated in Table 1.

Table 1: Eligible Participants by Wealth Quintile

District Dokolo Kasese Kyenjojo Mbale Mukono Kisoro Sembabule Buyende Total (N) Wealth quintile 2 54 140 141 96 102 67 102 85 787 (83%) Wealth quintile 3 7 12 22 35 28 15 30 11 160 (17%) Total (n) 61 152 163 131 130 82 132 96 947

The majority of the participants were found in private clinics, drug shops and pharmacies; Dokolo – 51%, 48% and 0% respectively, Kasese – 48%, 31% and 2% respectively, Kyenjojo – 42%, 57% and 1% respectively, Mbale – 66%, 27%, and 6% respectively, Mukono – 58%, 25%, and 14% respectively, Kisoro – 34%, 48%, and 18% respectively, and Sembabule – 32%, 42%, and 10% respectively. A few participants were found at private hospital, bar/lodge, and hotel. A total 947 customers from 256 private facilities in 51 sub counties were interviewed.

4.2 Social Demographic characteristics of the participants The majority 69% (n=655) of the participants were female, and the male participants were 31%. Further, majority of the participants fell under the age groups, 20-24 Yrs,24% (n=231). 25-29 Yrs, 26% (n=243) and 30-34 Yrs., 20% (n=192) (See Table 2).

In addition, regarding education level, 29% (n-=272) had completed primary 7 and 24% (n=232) had completed O level. Many of the participants were Catholics 34% (n=321) and Protestants 33% (n=315), followed by the Muslims 18% (n=170). Sixty-five percent (n=619) were married, while 25% (n=238) were not married (See Table 2).

Table 2: Social Demographic Characteristics of The Participants

Frequency (Number/Percentage) Survey District Dokolo Kasese Kyenjojo Mbale Mukono Kisoro Sembabule Buyende Total site N=61 N=152 N=163 N=131 N=130 N=82 N=132 N=96 N=947 Gender Female 56(92%) 109(72%) 129(79%) 91(69%) 90(69%) 54(66%) 84(66%) 42(44%) 655(69%} Male 5(8%) 44(29%) 34(21%) 40(31%) 40(31%) 28(34%) 48(34%) 54(56%) 293(31%) Age 15 - 19 Yrs 1(2%) 10(7%) 14(9%) 16(12%) 20(15%) 3(4%) 9(7%) 3(3%) 76 (8%) group 20 - 24 Yrs 12(20%) 31(20%) 46(28%) 33(25%) 35(27%) 17(21%) 31(23%) 26(27%) 231(24%) 25 - 29 Yrs 17(28%) 36(24%) 41(25%) 39(30%) 29(22%) 20(24%) 35(27%) 26(27%) 243(26%) 30 - 34 Yrs 18(30%) 30(20%) 23(14%) 23(18%) 24(18%) 21(26%) 29(22%) 24(25%) 192(20%) 35 - 39 Yrs 8(13%) 26(17%) 24(15%) 10(8%) 9(7%) 14(17%) 15(11%) 10(10%) 116(12%) 40 - 44 Yrs 3(5%) 15(10%) 6(4%) 7(5%) 2(2%) 5(6%) 7(5%) 6(6%) 51 (5%) 45 - 49 Yrs 2(3%) 3(2%) 6(4%) 2(2%) 8(6%) 2(2%) 4(3%) 27 (3%) 50 Yrs and above 2(1%) 3(2%) 1(1%) 3(2%) 2(2%) 1(1%) 12 (1%) Highest No formal education 5(3%) 9(7%) 7(9%) 13(10%) 2(2%) 36 (4%) level of Less than primary 7 26(43%) 17(11%) 55(34%) 24(18%) 28(22%) 23(28%) 33(25%) 31(32%) 237(25%) education Completed primary 7 19(31%) 60(39%) 42(26%) 31(24%) 32(25%) 18(22%) 33(25%) 37(39%) 272(29%) Completed O-level 12(20%) 55(36%) 37(23%) 36(28%) 31(24%) 7(9%) 33(25%) 21(22%) 232(24%) Completed A-level 1(2%) 7(5%) 9(6%) 14(11%) 11(9%) 9(11%) 3(2%) 3(3%) 57 (6%) Completed university 3(5%) 14(9%) 14(9%) 26(20%) 18(14%) 18(22%) 17(13%) 2(2%) 112(12%) or Tertiary institution Other 1(1%) 1(1%) 2 (0%) Religion Catholic 20(33%) 52(34%) 65(40%) 24(18%) 34(26%) 32(39%) 66(50%) 28(29%) 321(34%) Protestant 31(51%) 44(29%) 43(26%) 65(50%) 50(39%) 36(44%) 25(19%) 21(22%) 315(33%) Muslim 1(2%) 27(18%) 12(7%) 34(26%) 30(23%) 5(6%) 29(22%) 32(33%) 170(18%) Pentecostal 9(15%) 10(7%) 30(18%) 6(5%) 13(10%) 5(6%) 6(5%) 7(7%) 86 (9%) SDA 19(13%) 8(5%) 2(2%) 3(4%) 2(2%) 34 (4%) Other 5(3%) 2(2%) 1(1%) 6(5%) 6(6%) 20 (2%) Marital Married 52(85%) 99(65%) 101(62%) 79(60%) 56(43%) 59(72%) 96(73%) 77(80%) 619(65%) status Divorced/ Separated 3(5%) 13(9%) 20(12%) 11(8%) 17(13%) 4(5%) 10(8%) 3(3%) 81 (8%) Widow/ Widower 1(2%) 1(1%) 2(1%) 3(4%) 1(1%) 8 (1%) Never Married/single 5(2%) 39(26%) 40(25%) 40(31%) 57(44%) 16(20%) 26(20%) 15(16%) 238(25%) Not Applicable 1(1%) 1 (0%) *Note that %ages have been computed based on the results per district.

4.3 Findings by Survey Objectives In this section, we present the survey findings by Objective including: the lowest and highest monetary price that individuals are willing to pay for the products, the associations between price, quality and preference that influence willingness to pay, and identified research questions to inform more systematic and rigorous investigations on willingness to pay.

4.3.1 The range of acceptable prices for Protector condom, Injectaplan, and Pilplan Plus 4.3.1.1 Protector Condom Current price at which the participants bought Protector condom At least over 70% of the participants had bought Protector Condoms at the price of UGX 1000. 72% (n=159/221) of customers in wealth quintile 2 and 70% (n=38/54) in wealth quintile 3 had bought Protector Condoms at a price that ranged from UGX 1000 to 1500 (See Figure 2).

Figure 2: Current price that participants bought protector condoms

80% 72% 70% 70% 60% 50% 40% 30% Percentage 17% 17% 20% 15% 13% 13% 10% 5% 0% Less 1000 1001 to 1500 1501 to 2000 2500 and above

Price range (in UGX)

WQ2% WQ3%

Price at which protector condom would be so expensive for customers to consider buying it Findings (see table 3 below), reveal that over 99%of the participants would consider protector condom to be too expensive if priced at UGX 1000/= or more and that they would not consider buying it, the highest percentage gave a price of UGX 2000/= (29%). However, a very small percentage of about 1% indicated that they would still consider it to be too expensive even if priced below the RRP of UGX 700/= and they would not consider buying it.

Price at which protector condom would be so cheap that customers would feel the quality is not very good. Eighty eight percent (88%) of the participants indicated that if protector condom is priced at UGX 500/= or less would be considered to be too cheap and not of very good quality (a price lower than the RRP of UGX 700/=). Fifty nine percent (59%) i.e. UGX 500/= was the highest individual price percentage participants indicated was too low that they would feel the quality couldn’t be very good. However, 12% of the customers gave prices from UGX 1000/= and above (prices above the RRP) to be too low and that they would feel the quality couldn’t be very good (See Table 3).

Price at which customers would consider protector condom to be starting to get expensive but could still buy it. Up to 97% of the customers indicated that at UGX 1000/= they would consider protector condom start getting expensive but could still buy it which price was higher than the RRP of UGX 700. UGX 1500/= (41%) was the highest individual price percentage, respondents reported, followed by UGX 1000/= (22%) and UGX 2000/= (14%). All the remaining prices were less than 10% (See Table 3).

Price at which customers would consider protector condom to be a bargain-great buy for the money Survey findings indicate that 84% of the customers considered UGX 1000/= and above to be a bargain-great buy. Fifty seven percent (57%) i.e. UGX 1000/= was the highest individual price percentage participants indicated was a bargain-great buy, while approximately 9% for UGX 1500/= and 8% for UGX 2000/= a bargain-great buy. However, 15% of the customers considered UGX 500/= or less a bargain-great buy which price was also below the RRP of UGX 700/= (See Table 3 below). Table 3: Table showing prices at which customers would consider Protector Condoms to be too expensive, too cheap, starting to get expensive and a bargain-great buy for the money

Price in UGX So expensive I would Starting to get expensive A bargain-great buy for So low that I would feel the not consider buying it. but could still buy it. the money. quality couldn’t be very good. (n=355) (n=358) (n=358) (n=357)

<500 0.3% 0.8% 0.6% 28.6% 500 0.6% 2.0% 15.1% 59.1% 1000 13.8% 22.1% 57.0% 8.7% 1500 10.7% 41.3% 8.9% 0.3% 2000 29.3% 13.7% 8.1% 1.7% 2500 6.5% 3.4% 4.2% 0.3% 3000 18.0% 7.3% 2.5% 0.8% 3500 0.6% 0.8% 0.0% 0.0% 4000 3.1% 2.2% 0.6% 0.0% 4500 0.0% 0.8% 0.6% 0.0% 5000 12.1% 2.5% 1.4% 0.6% >5000 5.1% 3.1% 1.1% 0.0% Range of acceptable prices for Protector Condoms

Applying Van Westendorp’s analysis framework, the range of acceptable prices for Protector Condoms would be UGX 750 (lowest) to UGX 1800 (highest) (See Figure 3).

Figure 3: Range of acceptable prices for Protector Condom

95.0% 90.0% 85.0% Range of acceptable prices So expensive I would not consider buying it 80.0% 75.0% So low that I would feel the quality couldn’t be very good 70.0% 65.0% Starting to get expensive, but could still buy it 60.0% 55.0% A bargain-great buy for the money 50.0% 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 >5500

4.3.1.2 Injectaplan Current price at which the participants bought Injectaplan Thirty-one percent (31%, n=107/342) of the participants in wealth quintile 2 indicated that they had bought Injectaplan at a price range of UGX 2000 to 3000, and 29% (n=19/66) in wealth quintile 3 indicated the same. Thirty-two percent, 32% (n=21/66) of the participants in wealth quintile 3 indicated that they had bought Injectaplan at a price of UGX 4000 to 5000, while 27% (n=92/342) in wealth quintile 2 also indicated the same (see Figure 4).

Figure 4: Current price that participants bought Injectaplan

32% 35% 31%29% 30% 27% 25% 20% 20% 17% 15% 9%11% 11% 6% Percentage 10% 4% 3% 5% 2% 0% 0% 1000 to 2001 to 3001 to 4001 to 5001 to 6001 to Above 7000 2000 3000 4000 5000 6000 7000 Price range (in UGX)

WQ2% WQ3%

Price at which Injectaplan would be so expensive that customers would not consider buying it The findings revealed that eighty three percent (83%) of the customers indicated that they would consider Injectaplan too expensive that they would not consider buying it priced at UGX 5000/= or more( an amount way above the recommended retail price (RRP)of UGX 1600/=). UGX 5000/= and above (i.e. 61%) was the highest individual price percentage indicated by customers that they would not consider buying it., followed by UGX 5000/= with 22%, and UGX 3000 with 6.4%. (See Table 4).

Price at which Injectaplan would be so cheap that customers would feel the quality is not very good. Majority (66%) of the customers indicated that if injectaplan is priced at UGX 1500/= and below (below the RRP of UGX 1600/=), they would consider it so low and not of very good quality. UGX 1000/= and below (i.e. 40%) was the highest individual price percentage indicated by customers that they would consider Injectaplan to be so low that they would feel the quality couldn’t be very good. The second highest percentage indicated price was UGX 2000/= at 22.6%. However, 35% reported prices above the RRP (UGX 2000/= and more) as so low to be of good quality (See Table 4).

Price at which customers would consider Injectaplan to be starting to get expensive but could still buy it. Over 97% of the customers indicated that they would consider Injectaplan starting to get expensive but could still buy it if priced at UGX 2000/= and above, which price is higher than the RRP of UGX 1600/=, however a small percentage of customers (about 3%) indicated that even at UGX 1500/=, a price below the RRP, it would be expensive but still would buy it. UGX 5000/= and above (i.e. 30%), was the highest individual price percentage indicated by the customers consider Injectaplan to be starting to get expensive but could still buy it followed by UGX 5,000/= (23%), UGX 3000/= (14%) and UGX 4000/= (13%). (See Table 4)

Price at which customers would consider Injectaplan to be a bargain-great buy for the money The findings revealed that over 85% of the customers would still consider injectaplan to be a bargain-great buy for the money if priced above the RRP (UGX 1600/=) from UGX 2000/= and above. However, a small percentage of about 15% reported prices below the RRP (UGX 1500 and below). The highest individual price percentage indicated by the of customers as a great bargain was UGX 3000/= (i.e. 27%), followed by UGX 5,000/= (17%), UGX 2000/= (16.6%) and UGX 4000/= (9.8%). (See table 5 below). (See Table 4). Table 4: Table showing prices at which customers would consider Injectaplan to be too expensive, too cheap, starting to get expensive and a bargain-great buy for the money

So expensive I would Starting to get expensive A bargain-great buy So low that I would feel the not consider buying it. but could still buy it. for the money. quality couldn’t be very good. Price in UGX (n=467) (n=470) (n=471) (n=465) <500 0.0% 0.0% 0.0% 1.3% 500 0.0% 0.0% 1.3% 17.6% 1000 0.6% 0.6% 6.2% 40.0% 1500 0.6% 1.9% 7.2% 6.7% 2000 1.9% 4.7% 16.6% 22.6% 2500 1.3% 4.0% 5.9% 1.7% 3000 6.4% 13.8% 27.0% 6.7% 3500 1.3% 7.2% 0.8% 0.0% 4000 4.9% 13.0% 9.8% 0.9% 4500 0.0% 1.5% 2.8% 0.0% 5000 22.1% 23.4% 17.4% 2.2% >5000 60.8% 29.8% 5.1% 0.4% Range of acceptable prices for Injectaplan

Applying Van Westendorp’s analysis framework, the range of acceptable prices for Injectaplan would be 1500 UGX (lowest) to 5000 UGX (highest) (See Figure 5). Figure 5: Range of Acceptable Prices For Injectaplan

65.0% 60.0% So expensive I would not consider buying it So low I feel the quality is not very good 55.0% Starting to get expensive, but could still buy it A bargain-great buy for the money 50.0% 45.0% 40.0% 35.0% Range of acceptable prices 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 >5000

4.3.1.3 Pilplan Plus

Current price at which the participants bought Pilplan Plus Sixty-two percent (n=75/121) of the participants in wealth quintile 2 indicated that they had bought Pilplan Plus at a price range of UGX 1000 to 2000, and 48% (n=24/50) in wealth quintile 3 indicated the same. Additionally, 20% (n=10/50) in wealth quintile 3 indicated that they had bought Pilplan Plus at a price of 2000 to 3000, while 19% (n=23/121) in wealth quintile 2 indicated the same. Eighteen percent (n=9/50) of the participants in wealth quintile 3 indicated that they had bought Pilplan Plus at a price of 5000 UGX and above (See Figure 6).

Figure 6: Current price that participants bought Pilplan Plus

70% 62% 60% 48% 50% 40% 30% 19%20% 18% Percentage 20% 12% 8% 10% 5% 2% 2% 0% 1% 0% Less 1000 1000 to 2000 2001 to 3000 3001 to 4000 4001 to 5000 Above 5000 Price range (in UGX)

WQ2% WQ3%

Price at which Pilplan Plus would be so expensive that customers would not consider buying it

The findings revealed that over 97% of the customers would consider Pilplan Plus to be too expensive that they would not consider buying it if priced at UGX 2000/= and above (an amount above the RRP of UGX 1500/=). However, a small percentage of about 3% of the customers indicated that even if Pilplan plus is priced below the RRP, they would still consider it to be so expensive. The highest individual price percentage indicated by the of customers to be so expensive that would not consider buying it was UGX 5000/= (i.e. 34%), followed by UGX 5,000/= and above (24%), UGX 3000/= (16.7%) and UGX 4000/= (8.10%). (See Table 5)

Price at which Pilplan Plus would be so cheap that customers would feel the quality is not very good. The findings revealed that at a price of UGX 1000/= or less, 76% of the customers would consider Pilplan Plus to be priced so low that they would feel the quality couldn’t be very good, which price is lower than the RRP of UGX 1500/=. While 7% of the customers indicated a price equivalent to the RRP and 18% indicated prices above the RRP. The highest individual price percentage indicated by the of customers to be so low that they would feel the quality couldn’t be very good was UGX 1000/= (i.e. 34%), as well as UGX 500/= also at (34%), followed by UGX 2000/= (10%) and UGX 1500/= (6.8%). (See Table 5)

Price at which customers would consider Pilplan Plus to be starting to get expensive but could still buy it. About 90% of the customers reported that they would consider Pilplan Plus starting to get expensive but could still buy it if priced at UGX 2000/= and above (above the RRP of UGX 1500/=). There was a small percentage of customers of about 10% who indicated that even at the RRP or less, they still consider Pilplan to be starting to get expensive. The highest percentage of customers (22%) indicated a price of UGX 3000/= (See Table 5)

Price at which customers would consider Pilplan Plus to be a bargain-great buy for the money The findings revealed that over 59% of the customers indicated that Pilplan Plus would be a bargain-great buy when priced at UGX 2000/= or more, about 16% gave UGX 1500/= (an amount equivalent to the RRP) and over 25% prices below the RRP. The highest individual price percentage indicated by the of customers to be a bargain-great buy for the money was UGX 2000/= (i.e. 22%), followed by UGX 1000/= (20%) and UGX 3000/= (15%). (See Table 5).

Table 5: Table showing prices at which customers would consider Pilplan Plus to be too expensive, too cheap, starting to get expensive and a bargain-great buy for the money

Price in UGX So expensive I would not So low that I would feel Starting to get A bargain-great buy for consider buying it. the quality couldn’t be expensive but could still the money. (n=222) very good. buy it. (n=225) (n=221) (n=224) <500 0.0% 6.8% 0.4% 0.9% 500 0.5% 34.4% 0.4% 4.9% 1000 1.4% 34.4% 3.1% 19.6% 1500 0.9% 6.8% 6.3% 15.6% 2000 8.6% 10.0% 12.5% 21.8% 2500 3.2% 0.9% 9.4% 7.6% 3000 16.7% 3.6% 21.9% 15.1% 3500 0.9% 0.0% 3.6% 1.8% 4000 8.1% 1.4% 8.9% 3.6% 4500 1.4% 0.0% 3.1% 0.4% 5000 34.2% 1.8% 12.9% 6.7% >5000 24.3% 0.00% 17.4% 2.2% Range of acceptable prices for Pilplan Plus

Applying Van Westendorp’s analysis framework, the range of acceptable prices for Pilplan Plus would be UGX 1300 (lowest) to UGX 4550 (highest) (See Figure 7).

Figure 7: Range of Acceptable Prices For Pilplan Plus

45.0% So expensive I would not consider buying it 40.0% So low I feel the quality is not very good Starting to get expensive, but could still buy it 35.0% A bargain-great buy for the money 30.0% Range of acceptable prices 25.0%

20.0%

15.0%

10.0%

5.0%

0.0% 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 5500

4.3.2 The associations between price, quality and preference that influence willingness to pay

4.3.2.1 Aspects that influence willingness to pay for Protector Condoms Table 6 shows that overall, 63% (n=597/946) of the participants had seen or heard about Protector condom. Most of the participants 98% (n=584/597) indicated that they knew Protector Condoms as a birth control method (See Table 6)

Table 6: Participants’ Awareness and Knowledge Of Protector Condom

Dokolo Kasese Kyenjojo Mbale Mukono Kisoro Sembabule Buyende Total Awareness – seen or heard about Protector Condoms Yes 35(57%) 69(46%) 96(59%) 69(53%) 113(87%) 53(65%) 95(72%) 67(70%) 597(63%) No 26(43%) 83(54%) 67(41%) 62(47%) 17(13%) 29(35%) 37(28%) 29(30%) 349(37%) Total (N) 61 152 163 131 130 82 132 96 947 Know Protector Condoms as a birth control method Yes 35(100%) 68(99%) 96(100%) 68(99%) 110(97%) 52(98%) 93(98%) 62(93%) 584(98%) Total (N) 35 69 96 69 113 53 95 67 597 Attitudes towards Protector Condoms

The survey assessed participants’ attitudes towards Protector Condoms using statements related to brand appeal, brand quality and brand attributes as indicated in Table 7. The responses for strongly agree and agree to the statements were combined to derive one variable for those who had favorable attitudes towards Protector Condoms.

The findings indicate that for brand appeal, 73% (n=435) had trust in Protector Condoms, and 88% (n=526) liked its packaging. Regarding brand quality, 69% (n=414) of the participants indicated that Protector Condoms worked for them or were effective, while 70% (n=416) indicated that they have less side effects. For the brand attributes, 80% (n=447) indicated that the instructions for Protector Condoms were easy to understand, and 82% (n=489) indicated that It is easy to remove Protector Condoms from the packet. More so, 62% (n=372) indicated that Protector condom is the highest quality, while 63% (n=374) indicated that Protector Condoms do not burst easily (See Table 7)

Table 7: Statements indicating participants’ attitudes towards Protector Condoms

Attitudes towards Protector Condoms Measure Statements (Total N=597) Brand appeal Protector Condoms is the best brand 406 (68%) I trust Protector Condoms 435 (73%) I like Protector Condoms packaging 526 (88%) Brand quality Protector Condoms works for me/ is effective 414 (69%) Protector Condoms has less side effects 416 (70%) Brand attributes Protector condom is the highest quality 372 (62%) The instructions for Protector Condoms are easy to understand 447 (80%) It is easy to remove Protector Condoms from the packet 489 (82%) Protector Condoms do not burst easily 374 (63%) I like the smell of Protector Condoms 246 (41%)

Hypothetical associations between price, quality and preference that influence willingness to pay for Protector Condoms

We conducted non-parametric analysis for the survey data because variables were not normally distributed. Spearman rank correlation and a scatter plot were used for Protector Condoms. The correlations were weak and not statistically significant, hence the potential research hypotheses below:

1. Quality of Protector condom does not influence the maximum price payable by a customer. 2. Preference of Protector condom does not influence the maximum price payable by a customer. 3. Customer willingness to pay a maximum price for Protector condom is influenced by positive correlations between quality and preference.

4.3.2.2 Aspects that influence willingness to pay for Injectaplan Brand awareness and knowledge of Injectaplan Overall, 71% (n=670/947) of the participants had seen or heard about Injectaplan. Most of the participants 99% (n=666/670) indicated that they knew Injectaplan as a birth control method Table 8

Table 8: Participants’ awareness and knowledge of Injectaplan

Dokolo Kasese Kyenjojo Mbale Mukono Kisoro Ssembabule Buyende Total Seen or heard about Injectaplan Yes 56(92%) 89(61%) 150(92%) 77(59%) 89(69%) 58(71%) 96(73%) 55(57%) 670(71%) No 5(8%) 63(41%) 13(8%) 54(41%) 41(31%) 24(29%) 36(27%) 41(43%) 271(29%) Total (N) 61 152 163 131 130 82 132 96 947 Know Injectaplan as a birth control method Yes 56(100%) 89(100%) 149(99%) 75(97%) 89(100%) 58(100%) 95(99%) 55(100%) 666(99%) Total (N) 56 89 150 77 89 58 96 55 670

Attitudes towards Injectaplan We used statements for brand appeal, brand quality and brand attributes to assess participants’ attitudes towards Injectaplan. The responses for strongly agree and agree to the statements were combined to derive one analysis variable for those who had favorable attitudes towards Injectaplan.

Regarding brand appeal, 73% (n=487) of the participants indicated that they trust Injectaplan, while 86% (n=579) liked Injectaplan packaging. For brand quality, 65% (n=435) of the participants indicated that Injectaplan works for them or is effective. For the brand attributes, 83% (n=557) of the participants indicated that it is easy to remove Injectaplan from the packet, while 75% (n=501) indicated that the instructions for Injectaplan are easy to understand (See Table 9) Table 9: Statements indicating participants’ attitudes towards Injectaplan

Measure Statements Attitudes towards Injectaplan (Total N=670)

Brand Appeal Injectaplan is the best brand 453 (68%) I trust Injectaplan 487 (73%) I like Injectaplan packaging 579 (86%) Brand Quality Injectaplan works for me/ is effective 435 (65%) Injectaplan has fewer side effects 359 (54%) Brand Attributes Injectaplan is the highest quality 414 (62%) The instructions for Injectaplan are easy to understand 501 (75%) It is easy to remove Injectaplan from the packet 557 (83%) Hypothetical associations between price, quality and preference that influence willingness to pay for Injectaplan

We conducted non-parametric analysis for the survey data because variables were not normally distributed. Spearman rank correlation and a scatter plot were used for Injectaplan. The correlations were weak and not statistically significant, hence the following potential research hypotheses: 1. Quality of Injectaplan does not influence the maximum price payable by a customer. 2. Preference of Injectaplan does not influence the maximum price payable by a customer. 3. Customer willingness to pay a maximum price for Injectaplan is influenced by positive correlations between quality and preference.

4.3.2.3 Aspects that influence willingness to pay for Pilplan Plus Brand awareness and knowledge of Pilplan Plus Overall, 48% (n=449/947) of the participants had seen or heard about Pilplan Plus. Ninety-seven percent (n=437/449) indicated that they knew Pilplan Plus as a birth control method (See Table 10)

Table 10: Participants’ Awareness and Knowledge Of Pilplan Plus

Dokolo Kasese Kyenjojo Mbale Mukono Kisoro Sembabule Buyende Total Seen or Heard about Pilplan Plus Yes 41 (67%) 49(34%) 33(20%) 65(50%) 73(56%) 49(60%) 96(73%) 43(45%) 449(48%) No 20 (33%) 103(68%) 130(80%) 66(50%) 57(44%) 33(40%) 36(27%) 53(55%) 498(52%) Total (N) 61 152 163 131 130 82 132 96 947 Know Pilplan Plus as a birth control method Yes 40(98%) 48(98%) 33(100%) 61(94%) 71(97%) 49(100%) 93(97%) 42(98%) 437(97%) Total (N) 41 49 33 65 73 49 96 43 449

Attitudes towards Pilplan Plus We used statements for brand appeal, brand quality and brand attributes to assess participants’ attitudes towards Pilplan Plus. The responses for strongly agree and agree to the statements were combined to derive one analysis variable for those who had favorable attitudes towards Pilplan Plus.

Table 11 shows that for brand appeal, 74% (n=334) of the participants like Pilplan Plus packaging, while 55% (n=247) trust Pilplan Plus. Regarding brand quality, 46% (n=207) indicated that Pilplan Plus works for them, and 43% (n=193) indicated that it has fewer side effects. For brand attributes, 77% (n=347) of the participants indicated that It is easy to remove Pilplan Plus from the packet, while 67% (n=301) indicated that the instructions for Pilplan Plus are easy to understand (See Table 11)

Table 11: Statements indicating participants’ attitudes towards Pilplan Plus

Measure Statements Attitudes towards Pilplan Plus (Total N=449) Brand Appeal Pilplan Plus is the best brand 224 (50%) I trust Pilplan Plus 247 (55%) I like Pilplan Plus packaging 334 (74%) Brand Quality Pilplan Plus works for me 207 (46%) Pilplan Plus has less side effects 193 (43%) Brand Attribute Pilplan Plus is the highest quality 191 (43%) The instructions for Pilplan Plus are easy to understand 301 (67%) It is easy to remove Pilplan Plus from the packet 347 (77%)

Hypothetical associations between price, quality and preference that influence willingness to pay for Pilplan Plus

We conducted non-parametric analysis for the data because variables were not normally distributed. Spearman rank correlation and a scatter plot were used for Pilplan Plus. The correlations were weak and not statistically significant. This yielded the following potential research hypotheses: 1. Quality of Pilplan Plus does not influence the maximum price payable by a customer. 2. Preference of Pilplan Plus does not influence the maximum price payable by a customer. 3. Customer willingness to pay a maximum price for Pilplan Plus is influenced by positive correlations between quality and preference.

4.3.3 Research questions to inform more systematic and rigorous investigations Since there is limited research targeting the private sector health providers and services, it is important to conduct additional systematic and rigorous research to validate the findings of this survey. The key areas for further research include; Anthropological customer profile studies that focus on: 1. What, who, why, when, what of the buying experience among new customers, switching and relapse customers 2. Operator attributes that attract customers, re; readiness, competence and skill? 3. Social norms that influence towards buying family planning products from private facilities, sources, drivers, and factors affecting the positive norms.

Behavioral customer studies focusing on;

1. How and what have customers perceived and positioned the purchase and use of socially marketed products in their daily expenditure budget? 2. How and what have peers influenced the ‘’new’’ behavior of purchase of socially marketed products amongst all categories of users, re; new customers, switching and relapse customers

4.3.4 Challenges faced during field data collection The research team encountered challenges during the field data collection exercise and identified stakeholder recommendations that can be used to inform future surveys of a similar nature. They include; 1. It was noted that most people visit the private outlets late in the evenings (from 6:00 pm until late) to buy the contraceptive/family planning products, thus it was a bit challenging to get many participants/customers during the day (before 6:00 pm), and those identified during the day were always in a rush. The research team effectively utilized market days in the respective survey sites to reach a big number of customers as most of the outlet owners indicated that many customers visit the outlets for family planning services on such days.

2. Most of the retail outlets visited indicated that the subsidized family planning products were on very high demand but not available and out of stock thus attracting very high retail prices, i.e. over 100% of the recommended retail price (RRP). The distribution mechanism to the retail channels outlets in the community was not very clear to the retail operators, coupled with inadequate marketing and communication activities.

3. The district leadership and most retail outlet owners indicated that limited research has been done in the country with private sector health providers, thus some retail owners first mistook the exercise as a crackdown by the National Drug Authority, but the team worked with the community leaders and the Village Health Teams to create rapport with the retail outlet owners to enable their participation in the survey. Additionally, the district leadership requested for the findings of this survey to be shared extensively given that there is limited research on the subject in Uganda.

4.3.5 Limitations of the survey Lack of randomization in the sampling makes the results not generalizable. This is compounded by the fact that results were not normally distributed. As such, we could not with confidence state the levels of significance for the primary variables of highest and maximum price, quality and preference.

5.0 Implications for programming The survey findings highlight that acceptable price range for a package of Protector Condoms is UGX 750/= lowest and UGX 1800/= highest, and Injectaplan the lowest is UGX 1500/= and highest is UGX 5000/=, and Pilplan Plus the lowest is UGX 1300/= and highest is UGX 4550/=. It is thus important to consider these price ranges for the three products to inform programming and market pricing of the products.

6.0 Conclusion This survey confirmed that both men and women are willing to pay for the three USAID socially marketed products – Protector Condoms, Injectaplan and Pilplan Plus, provided by the private retail outlets. However, key to note is that the price range they were willing to pay for the three products significantly varied by optimal price. Therefore, the results of this survey should be used to inform the recommended consumer price and market pricing strategy for the three products.

7.0 APPENDIX I: INDIVIDUAL CUSTOMER QUESTIONNAIRE

Hello! My name is ______, I work for USAID/Communication for Healthy Communities (CHC) project- Obulamu? CHC is currently implementing a social marketing activity involving promotion of Pilplan Plus, Injectaplan and Protector Condoms, which aim at preventing pregnancy, sexually transmitted infections, and HIVAIDS respectively. The purpose of this interview is to contribute to better planning of social marketing activities. I would like to ask you some questions about these products. Eight districts are participating in this activity. The interview duration will be about 30 minutes. I would be very grateful if you would answer a few questions. Everything you say will be confidential and no name will be recorded. Participation is voluntary. You are free to leave the interview at any time, without consequences to your health care anywhere. There are no direct benefits due to participation.

Eligibility for screening Before we proceed, I would like to establish whether you have/own the following as an individual Options for have? Y=1 N=0 Options for own? Y=1 N=0 Electricity/Solar A watch A radio A bicycle A cassette player A motorcycle or scooter A television An animal drawn cart A mobile phone A car or truck A fixed phone A boat with a motor A refrigerator A boat without a motor A table A mobile phone A chair A sofa set A bed A cupboard A clock Total Score Total Score Note: If customer scores a total of <5 and above 15 don’t proceed with the interview

Participants details Participant ID_ (Region/ District/ Subcounty/ Number) E.g E/M/K/001 Residence; Peri-urban Urban Date of Interview mm/dd/yy Interviewer name Social Demographic Characteristics 001 Gender 1= Male 2=Female 002 How old are you? Age………., DOB (mm/dd/yy) …../…../…… 003 What was the highest level of education completed? 1= No formal education 2= Less than primary 7 3= Completed primary 7 4= Completed O-level 5= Completed A-level 6= Completed university or Tertially institution 7= Not Applicable 8= Don’t know 9= Other specify) 004 What is your religion? 1=Catholic 2=Protestant 3=Muslim 4=Pentecostal 5=SDA 6=Other (Specify) 005 What is your present marital status? 1= Married 2= Divorced/ Separated 3= Widow/ Widower 4= Never Married/single 5= Not Applicable 006 What is your district of residence? 1= Dokolo 2= Kasese 3= Kyenjojo 4= Mbale 5=Mukono 6=Kisoro 7=Ssembabule 8=Buyende 007 Village 008 Subcounty 009 Record the outlet category e.g (Pharmacy, Clinic, Drug 1=Pharmacy shop, etc..) 2=Private Clinic 3=Drug shop 4=Private Hospital 5=Dduuka 6=Supermarket 7=Bar/lodge 8=Kiosk 9=Hotel 10= Other (Specify) 010 Name of Outlet …………………………………………..

SECTION ONE: KNOWLEDGE Interviewer: I would like to ask you whether you have seen and/ or heard these products. (Explain to the respondents that you will be asking a series of questions about Protector Condoms, Pilplan Plus, and Injectaplan.) 1. Injectaplan (show participant the advertised brand image) 2. Pilplan Plus (show participant the advertised brand image) 3. Protector Condoms (show participant the advertised brand image)

Ask the following three questions for Injectaplan, there after ask the same questions for Pilplan Plus and finally ask the same questions for Protector Condoms No. Question Response code Skip/score 100 Do you know the product as a birth control 1=Yes If No/ Not sure= method? 2=No Terminate Interview 3=Not sure 101a Do you know any other source where you can 1=Yes If No= Go To 102 access the product? 2=No 3=Not sure 101b If Yes, mention the source 102 When was the last TIME you bought any of the 1=≤ 7 days product? 2 =≤ one month 3= 3 months 4= 6 months plus 5= Not Applicable 103 At what price would you consider this product so expensive that you would not consider buying it? 104 At what price would you consider the product to be priced so low that you would feel the quality couldn’t be very good? 105 At what price would you consider (Product Name) starting to get expensive, but you could still buy it? 106 At what price would you consider (Product Name) to be a bargain-great buy for the money?

SECTION TWO: WILLINGNESS TO PAY FOR THE PRODUCTS 2.1 Assessing customers capacity to pay Interviewer; I would like to ask you some questions on your livelihood Number Question Response Score 200 How many members does your 1.Nine on more 0 household have? 2. Eight 3 3. Seven 4 4. Five or six 6 5. Four 8 6. Three 12 7. Two 21 8. One 28 201 Are all the household members aged 6 to 1. No 0 12 currently in school? 2. Yes 5 3. No one aged 6 to 12 9 202 Can the (oldest) female head/spouse 1. N o 0 read and write with understanding in any 2. No female head/spouse 0 language? 3. Yes 3 203 What type of material is mainly used for 1. Unburnt bricks with mud, mud and poles, or 0 construction of the wall of the dwelling? other 5 2. Unburnt bricks with cement, wood, tin/iron sheets, concrete/stones, burnt stabilized bricks, or cement blocks 204 What type of material is mainly used for 1. Thatch, or tins 0 construction of the roof of the dwelling? 2. Iron sheets, concrete, tiles, asbestos, or 5 other

WEALTH QUINTILE I am going to ask you questions about possessions in your household, what household members own: Number Question Response Skip 205 Does your household have? 1. Electricity/Solar Ask All Participants Again 2. Radio 3. Cassette player 4. Television 5. Mobile phone 6. fixed phone 7. Refrigerator 8. Table 9. Chair 10. Sofa set 11. Bed 12. Cupboard 13. Clock 206 Does any member of you household own? Watch ASK ALL PARTICIPANTS AGAIN Bicycle Motorcycle or scooter Animal drawn cart Car or truck Boat with a motor Boat without a motor Mobile phone

BRAND PERCEPTION Interviewer; Think about the product images I have shown you above and tell me whether you Strongly Agree, Agree, Disagree, Strongly Disagree And Don’t Know. Ask the following three questions for Injectaplan, there after ask the same questions for Pilplan Plus and finally ask the same questions for Protector Condoms. Mention (Product Name) to the respondent for each question where indicated. (Product Name) = Injectaplan, Pilplan Plus, Protector. Appeal Number Question Response Score 300 (Product Name) is the best brand 1.Strongly agree 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know 301 I trust (Product Name) 1.Strongly agree 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know 302 I like (Product Name) packaging 1.Strongly agree 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know Quality 303 (Product Name) works for me/ is effective 1.Strongly agree 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know 304 (Product Name) has less side effects 1.Strongly agree 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know

BRAND PERCEPTION (Cont.)

Attributes 305 (Product Name) is the highest quality 1.Strongly agree 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know 306 The instructions for (Product Name) are easy to 1.Strongly agree understand 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know It is easy to remove (Product Name) from the packet 1.Strongly agree 307 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know Additional for Protector Condoms Protector Condoms do not burst easily 1.Strongly agree 308 2. Agree 3. Disagree 4. Strongly disagree 5. Don’t’ Know I like the smell of Protector Condoms 1.Strongly agree 2. Agree 309 3. Disagree 4. Strongly disagree 5. Don’t’ Know

Interviewer; I would like us to recap about your willingness to pay for the three products Number Question Response Score 400 If the price of (Product Name) increased 1. Yes by UGX 500 of the amount you paid, 2. No would you continue to buy (Product 3. Don’t’ Know Name) 401 What is the maximum price would be willing to pay for (Product Name)

8.0 References

1. Braun C, Rehdanz K, Schmidt U (2016) Validity of Willingness to pay measures under preference uncertainty. PLOS ONE 11(4): e0154078. https://doi.org/10.1371/journal.pone.0154078 2. Evans W. et al (2019) Willingness to pay for Condoms among men in sub-Saharan Africa. Int Journal of Environmental Research and Public Health (16) 34; https://doi:10.3390/ijerph16010034 3. Foreit JR. (2003) The reliability and validity of willingness to pay surveys for reproductive health financing pricing decisions in developing countries. Health Policy (63), 37-47 4. Hardee, K., Wofford, D., & Thatte, N. (2017). Partnering with the private sector to strengthen provision of contraception. https://knowledgecommons.popcouncil.org/departments_sbsr-rh/222/ 5. Jones, C. & Kadirov, K.K. (2017). Landscaping the Condom Market in Uganda: Applying the TMA lens to identify programmatic gaps and sustainable solutions to support delivery and use of Condoms. Kampala, Uganda: USAID. 6. Nalwadda, G., Mirembe, F., Byamugisha, J., Tumwesigye, N. M., & Faxelid, E. (2016). Young peoples’ interface with providers of contraceptive care: a simulated client survey in two Ugandan districts. Contraception and reproductive medicine, 1(1), 15. 7. Onwujekwe O. et al (2013) Willingness to pay and benefit-cost analysis of modern contraceptives in Nigeria. Int journal of gynaecology and obstetrics (122) 94-98 http://dx.doi.org/10.1016/j.ijgo.2013.03.024 8. P. H van Westendorp, “NSS Price Sensitivity Meter (PSM)—A New Approach to study Consumer-Perception of Prices,” Proceedings of the 29th ESOMAR Congress, Venice, 5-9 September 1976, pp. 139-167. 9. Prata N. et al (2013) Potential for cost recovery: women’s willingness to pay for injectable contraceptives in Tigray, Ethiopia. PLoS ONE 8(5): e64032. doi: 10.1371/journal.pone.0064032 10. Sharma, S., & Dayaratna, V. (2005). Creating conditions for greater private sector participation in achieving contraceptive security. Health Policy, 71(3), 347-357. 11. Uganda Bureau of Statistics (UBOS) and ICF. 2018. Uganda Demographic and Health Survey 2016. Kampala, Uganda and Rockville, Maryland, USA: UBOS and ICF.