The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi.
Stevens, Warren;
Wiseman, Virginia;
Ortiz, Juan;
Chavasse, Desmond;
(2005)
The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi.
Malaria journal, 4 (1).
22-.
ISSN 1475-2875
DOI: https://doi.org/10.1186/1475-2875-4-22
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BACKGROUND: Insecticide-treated nets (ITNs) 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 ITNs were sold. METHODS: The costs were calculated retrospectively through analysis of expenditure data. Costs and effects were measured as cost per treated-net year (cost/TNY) and cost per net distributed. RESULTS: The mean cost/TNY was calculated at $4.41, and the mean cost/ITN distributed at $2.63. It also shows evidence of economies of scale, with the cost/TNY falling from $7.69 in year one (72,196 ITN) to $3.44 in year five (720,577 ITN). Cost/ITN distributed dropped from $5.04 to $1.92. CONCLUSION: 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.
