Socio-economic inequity in demand for insecticide-treated nets, in-door residual house spraying, larviciding and fogging in Sudan

Obinna Onwujekwe,El-Fatih Mohamed Malik,Sara Hassan Mustafa,Abraham Mnzava

doi:10.1186/1475-2875-4-62

Abstract

BackgroundIn order to optimally prioritize and use public and private budgets for equitable malaria vector control, there is a need to determine the level and determinants of consumer demand for different vector control tools.ObjectivesTo determine the demand from people of different socio-economic groups for indoor residual house-spraying (IRHS), insecticide-treated nets (ITNs), larviciding with chemicals (LWC), and space spraying/fogging (SS) and the disease control implications of the result.MethodsRatings and levels of willingness-to-pay (WTP) for the vector control tools were determined using a random cross-sectional sample of 720 householdes drawn from two states. WTP was elicited using the bidding game. An asset-based socio-economic status (SES) index was used to explore whether WTP was related to SES of the respondents.ResultsIRHS received the highest proportion of highest preferred rating (41.0%) followed by ITNs (23.1%). However, ITNs had the highest mean WTP followed by IRHS, while LWC had the least. The regression analysis showed that SES was positively and statistically significantly related to WTP across the four vector control tools and that the respondents' rating of IRHS and ITNs significantly explained their levels of WTP for the two tools.ConclusionPeople were willing to pay for all the vector-control tools, but the demand for the vector control tools was related to the SES of the respondents. Hence, it is vital that there are public policies and financing mechanisms to ensure equitable provision and utilisation of vector control tools, as well as protecting the poor from cost-sharing arrangements.

Highlights

Malaria is the major health problem in Sudan and its prevention in the country is managed through official vector control strategies, which include annual indoor residual house spraying (IRHS), larviciding with chemicals (LWC), fogging or space spraying (SS) and recently insecticidetreated nets (ITNs)
People were willing to pay for all the vector-control tools, but the demand for the vector control tools was related to the socio-economic status (SES) of the respondents
This paper presents the findings of a study to determine how different socio-economic groups prefer and demand different malaria vector control strategies

Summary

Introduction

Malaria is the major health problem in Sudan and its prevention in the country is managed through official vector control strategies, which include annual indoor residual house spraying (IRHS), larviciding with chemicals (LWC), fogging or space spraying (SS) and recently insecticidetreated nets (ITNs). In order to maximize the limited public and private budget for malaria vector control, there is the need to determine the extent of consumer demand for different vector control tools. Basing resource-allocation decisions for vector control on consumer preferences would ensure that the strategies are effectively implemented and sustained over the long-term as the ability to sustain disease control depends very much on "listening to the people" [3]. In order to optimally prioritize and use public and private budgets for equitable malaria vector control, there is a need to determine the level and determinants of consumer demand for different vector control tools

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Discussion

Conclusion