The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi

Abstract

Background: Insecticide treated nets (ITN) are a proven intervention to reduce the burden of malaria, yet there remains a debate as to the best method of ensuring they are universally utilized. This study is a cost-effectiveness analysis of an intervention in Malawi that started in 1998 in Blantyre district before expanding nationwide. Over the 5-year period 1.5 million ITN were sold.
Methods: The costs were calculated retrospectively through analysis of expenditure data. Cost-effectiveness ratios were measured as cost per treated net year (cost/TNY) and cost per net distributed.
Results: The mean cost/TNY was calculated at $4.17, and the mean cost/ITN distributed at $2.49. It also shows evidence of economies of scale, with the cost/TNY falling from $7.92 in year one (72,196 ITN) to $2.95 in year five (720,577 ITN). Cost/ITN distributed dropped from $5.18 to $1.64.
Conclusions: Combining targeting and social marketing has the potential of being both cost-effective and capable of achieving high levels of coverage, and it is possible that increasing returns to scale can be achieved.

Citation

Malaria Journal (2005) 4 (1) 22-27 {doi: 10.1186/1475-2875-4-22]

The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi

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