Spectacle Dispensing in Timor-Leste: Tiered-pricing, Cross-subsidization and Financial Viability

Abstract

Purpose: To examine the financial viability of the Timor-Leste National Spectacle Program as it increases spectacle availability, affordability and uptake, particularly for Timor’s poor.

Methods: In rural areas, three models of ready-made spectacles were dispensed according to a tiered pricing structure of US$3.00, 1.00, 0.10 and 0.00. In addition, custom-made spectacles were available in the capital, Dili. Spectacle costs, dispensing data and income for the National Spectacle Program for 18 months from March 2007 were analyzed.

Results: Rural services dispensed 3415 readymade spectacles: 47.1% to women, and 51.4% at subsidized prices, being 39.8% at US$0.10 and 11.6% free. A profit of US$1,529 was generated, mainly from the sale of US$3.00 spectacles. Women (odds ratio, OR, 1.3, 95% confidence interval, CI, 1.1–1.4) and consumers aged ≥65 years (OR 2.1; 95% CI 1.7–2.6) were more likely to receive subsidized spectacles. Urban services dispensed 2768 spectacles; mostly US$3.00 readymade (52.8%) and custom-made single vision (29.6%) units. Custom-made spectacles accounted for 36.7% of dispensing, but 73.1% of the US$12,264 urban profit. The combined rural and urban profit covered all rural costs, leaving US$2,200 to meet administration and other urban expenses.

Conclusion: It is instructive and encouraging that a national spectacle dispensing program in one of the ten poorest countries of the world can use tiered-pricing based on willingness-to-pay information to cover spectacle stock replacement costs and produce profit, while using cross-subsidization to provide spectacles to the poor.

KEYWORDS::

• Cost recovery
• Cross-subsidization
• Gender
• Spectacles
• Tiered-pricing
• Timor-Leste

ACKNOWLEDGMENTS

The Timor-Leste National Spectacle Program is managed by a partnership of local nongovernment organization Fo Naroman Timor-Leste (FNTL), the Timor-Leste Ministry of Health, and The Fred Hollows Foundation New Zealand. The authors thank FNTL for making available the data used in this analysis.

Financial Support: This analysis was in part funded by the New Zealand Agency for International Development (NZAID).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.