Which distribution systems reach the poor? Equity of coverage of never treated nets, ever treated nets, and immunisation, to reduce child mortality in Africa
Background: Insecticide treated nets (ITNs) and childhood vaccination are two of the most powerful interventions available to prevent childhood mortality in Africa, but ITN coverage is still very low. Current debates about how to increase ITN coverage are concerned with the roles of different supply and distribution systems, in particular whether or not commercial net markets have any useful role to play. In this paper, the authors compile and analyse data from nationally representative surveys in 26 African countries, to compare equity of coverage of a) EPI immunisation, b) any-net, c) ITNs ever treated nets;: and d) untreated mosquito nets never treated nets). It was assumed that ever treated net coverage mostly reflects the activities of public health programmes and projects, and that never treated net coverage mostly reflects the activity of local unsubsidised commercial markets. We discuss the validity, limitations, and possible biases of these assumptions.
Lancet Infectious Diseases (2005) 5 (11) 709-717 [doi:10.1016/S1473-3099(05)70269-3]