Abstract
ObjectiveThis study aims to provide a better understanding of the amounts spent on different malaria prevention products and the determinants of these expenditures.Methods1,601 households were interviewed about their expenditure on malaria mosquito nets in the past five years, net re-treatments in the past six months and other expenditures prevention in the past two weeks. Simple random sampling was used to select villages and streets while convenience sampling was used to select households. Expenditure was compared across bed nets, aerosols, coils, indoor spraying, using smoke, drinking herbs and cleaning outside environment.Findings68% of households owned at least one bed net and 27% had treated their nets in the past six months. 29% were unable to afford a net. Every fortnight, households spent an average of US $0.18 on nets and their treatment, constituting about 47% of total prevention expenditure. Sprays, repellents and coils made up 50% of total fortnightly expenditure (US$0.21). Factors positively related to expenditure were household wealth, years of education of household head, household head being married and rainy season. Poor quality roads and living in a rural area had a negative impact on expenditure.ConclusionExpenditure on bed nets and on alternative malaria prevention products was comparable. Poor households living in rural areas spend significantly less on all forms of malaria prevention compared to their richer counterparts. Breaking the cycle between malaria and poverty is one of the biggest challenges facing malaria control programmes in Africa.
Highlights
The provision of insecticide-treated nets (ITNs) in malarious regions is widely accepted as an essential public health service [1,2]
Poor households living in rural areas spend significantly less on all forms of malaria prevention compared to their richer counterparts
This study does not show that poor households are investing a wide variety of prevention products that absorb a significant amount of their income
Summary
The provision of insecticide-treated nets (ITNs) in malarious regions is widely accepted as an essential public health service [1,2]. One of the key reasons cited for this is that when used properly, intact ITNs provide almost complete protection from mosquito bites [3]. Studies have demonstrated the efficacy of ITNs with an overall reduction in all-cause mortality of 17% [4]. The cost-effectiveness of ITNs relative to other forms of malaria prevention and treatment has been widely demonstrated [510]. According to some experts in the field, some of these products are likely to give partial protection [13,14]. Some studies show that coils can have a protective effect against mosquito biting but this varies according to the ingredients and the conditions under which they are used [15,16,17,18,19,20,21]
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