Should Governments Subsidize the Use of Insecticide-Impregnated Mosquito Nets in Africa? Implications of a Cost-Effectiveness Analysis

Evans, David B.; Azene, Girma; Kirigia, Joses Muthuri

doi:10.1093/heapol/12.2.107

Cited by 38 publications

(26 citation statements)

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“…[21][22][23] The issue of a public subsidy for impregnated bed nets also needs to be seriously considered. 8,9 …”

Section: Discussionmentioning

confidence: 99%

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Factors influencing the use of bed nets in Mbarara municipality of Uganda.

Nuwaha¹

2001

Am J Trop Med Hyg

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Abstract. In order to identify independent predictors for bed net use, respondents from 643 households selected randomly from 21 clusters were interviewed in Mbarara municipality, Uganda. Respondents answered questions about demographic characteristics, social economic conditions, causes and transmission of malaria, beliefs about severity and complications of malaria, malaria morbidity and health care-seeking behavior, perceived control of malaria prevention, beliefs about utility of bed nets, perceived susceptibility to malaria, and whether they use bed nets or not. Univariate and multivariate logistic regression analyses were used to identify predictors for bed net use. Fifty-five percent (356 of 643) of the households had bed net users. The independent factors that favored bed net use were as follows: 1) age Ͻ 30 years, 2) ownership of a television, 3) having mosquito nets in ventilators of the house, 4) being a skilled worker or a professional, or owning a major business, 5) living in a permanent house, 6) believing that bed nets prevent malaria, 7) believing that bed nets are worth their cost, 8) not believing that convulsions cannot be cured by modern medicine, and 9) believing that bed nets are not expensive. The strongest predictors of bed net use are living in a permanent house and agreeing that bed nets are worth their cost, with adjusted odds ratios of 4.29 (95% confidence interval, 2.76-6.71) and 3.93 (95% confidence interval, 2.5-26.13), respectively. These data suggest that in order to increase the use of bed nets, the price of bed nets needs to be reduced and educational messages that stress the favorable use of bed nets need to be increased.

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“…[21][22][23] The issue of a public subsidy for impregnated bed nets also needs to be seriously considered. 8,9 …”

Section: Discussionmentioning

confidence: 99%

“…Insecticide-impregnated bed nets significantly reduce mortality and morbidity, as well as the incidence of severe malaria. [3][4][5][6][7] They are also cost effective, 8,9 and if used widely, they may delay the spread of chloroquine resistance. The use of bed nets is therefore a priority for malaria control in sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the use of bed nets in Mbarara municipality of Uganda.

Nuwaha¹

2001

Am J Trop Med Hyg

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“…The main occupation in the district is subsistence farming and livestock rearing. KND is in the poorest region of Ghana where 88% (more than doubles the figures in southern Ghana) of people live below the poverty line [13] The KND lies in the Guinea-Sudan Savannah transition zone and is characterized by a dry climate with a single rainfall regime 1 and two distinct seasons: the dry and wet seasons. Mean temperatures range from a minimum of 20°C to a maximum of 42°C.…”

Section: The Settingmentioning

confidence: 99%

“…Malaria remains the most important vectortransmitted human disease [1]. It has been and remains an epidemic in most parts of Sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

Malaria treatment in Northern Ghana: What is the treatment cost per case to households?

Akazili¹,

Aikins²,

Binka³

2008

African Journal of Health Sciences

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SUMMARYAlthough malaria is a major problem in Sub-Saharan African countries including Ghana, there has been little research on its economic impact, particularly the treatment cost at the household level. This study uses data collected from a random sample of 423 households in Kassena-Nankana district (KND) of northern Ghana. Malaria was ascertained through selfreporting of symptoms using a one-month recall period. The paper presents treatment cost analysis of seeking malaria care to households. Direct and indirect costs to households are estimated and examined in terms of location, severity, and wealth. The study shows that indirect cost accounts for 71 percent of total cost of a malaria episode. While cost of malaria care is estimated at 1 percent of the income of the rich, it is 34 percent of the poor households' income, suggesting that the burden of malaria is higher for poorer households. In order to reduce the cost of malaria to households, we recommend that the training of malaria volunteers to assist households in the communities to take more responsibility of the disease and also to intensify public education to promote the use of insecticide treated nets, as they have been found to be cost-effective in the prevention of malaria.

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“…Cost-effectiveness calculations have suggested that ITNs and childhood vaccinations are of similar value (about US$20 per prevented disabilityadjusted life year in one study). 4 Vaccines are provided free of charge, and a strong case can be made for donors, nongovernmental organisations, and governments to work together to provide free or heavily subsidised ITNs and their retreatment, at least for vulnerable groups such as young children and pregnant women. A second question for the promoters of ITNs is posed in a hypothesis also in today's Lancet.…”

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confidence: 99%