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Free Content Too poor to pay: charging for insecticide-treated bednets in highland Kenya

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Abstract:

Summary

WHO has proposed malaria control as a means to alleviate poverty. One of its targets includes a 30-fold increase in insecticide-treated nets (ITNs) in the next 5 years. How this service will be financed remains unclear. In July 2000, 390 homesteads in rural highland Kenya were interviewed on their willingness to pay for ITNs. The costs to a household of protecting themselves with ITNs were compared with current household expenditure. Homesteads expressed a willingness to pay for ITNs, but the amounts offered were not sufficient to cover the costs of providing this service without donor support to meet the difference. Furthermore, as most household expenditure was allocated to basic needs these interventions were ‘unaffordable’. The cost of protecting a household with ITNs would be equivalent to sending three children to primary school for a year. The aspiration by poor rural homesteads to protect themselves with ITNs is not compatible with their ability to pay. One option to have an immediate equitable impact on ITN coverage and break the cycle between malaria and poverty is to provide this service free of charge.

Keywords: Kenya; affordability; cost; expenditure; insecticide-treated bednets; willingness-to-pay

Document Type: Research Article

DOI: http://dx.doi.org/10.1046/j.1365-3156.2002.00929.x

Affiliations: 1: Wellcome Trust Research Laboratories/KEMRI, Nairobi, Kenya and Centre for Tropical Medicine, University of Oxford,   John Radcliffe Hospital, Oxford, UK. 2: Division of Malaria Control, Ministry of Health, Nairobi, Kenya

Publication date: October 1, 2002

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