Research
The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi
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* Corresponding author: Warren Stevens wstevens@mrc.gm
1 MRC Laboratories, PO Box 273, Banjul, The Gambia
2 Health Policy Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
3 UNICEF, P.O. Box 30375. Lilongwe 3, Malawi
4 PSI Malaria Department, Po Box 22591-0400, Nairobi, Kenya
Malaria Journal 2005, 4:22 doi:10.1186/1475-2875-4-22
Published: 10 May 2005Abstract
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.