RESUMEN
This study presents a willingness-to-pay (WtP) questionnaire that was designed, validated, and applied to assess perceptions of air quality and self-reported health in two middle-income South American cities: Barcelona and its neighboring cities (Venezuela) and Guayaquil (Ecuador). These cities lack air quality monitoring and control measures. The questionnaire is a reliable tool to assess air quality based on citizens' perceptions, and the results reveal that both populations perceive low air quality and accurately identify emission sources and air pollutants (industrial emissions and particulate matter in Barcelona and vehicular emissions and carbon monoxide in Guayaquil). The study also evaluated the efforts made by both cities to improve air quality using the United Nations Environment Programme to strengthen air quality in South America. Based on this evaluation, strengths were identified for enhancing air quality in both cities. The study finds that in Barcelona and its surroundings, investment is needed to improve urban transport, waste management, and update the environmental legislation regarding air quality at the national level. In contrast, Guayaquil has already taken some measures to improve air quality, but more investment in public transport and measures to lower vehicle emissions are needed.