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...$856 per death averted [15]. In Malawi, a study of social marketing programme which delivered heavily subsidized nets through health facilities reported a figure of approximately $3 per net delivered =-=[16]-=-. In line with other evaluations the costs presented here represent an economic cost [3,17]. Importantly, we have attempted to capture as fully as possible all costs associated with running a national...

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...ket expense to the consumer while at the same time encouraging market growth of ITNs [16]. Other programmes make use of market segmentation to offer differently priced nets to different target groups =-=[17]-=-. A key to making such interventions more effective and sustainable in the long term is understanding what drives the purchase and use of ITNs, as well as other malaria prevention methods. Few studies...

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...fordjournals.org/ D ow nloaded from Although our estimated direct distribution costs in relatively prosperous peri-urban areas were similar to those reported by large distribution projects elsewhere (=-=Stevens et al. 2005-=-), costs were much higher in smaller, poorer, more remote rural communities. This reflects differences in population size, local purchasing power and cost of transportation of staff and nets. In our m...

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...an be compared across studies using different ITN products, the number of TNYs from LLINs distributed can be expressed as the total number of LLINs multiplied by the expected life of the net in years =-=[9,28,29]-=-. For the present study both the cost per LLIN delivered and the cost per TNY are reported. To account for the fact that not all LLINs distributed are retained or regularly used by target populations,...

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...be complex and not clearly present in all reviewed programmes. In Malawi this effect is well documented and the cost per unit in the 5 th year of operation fell to approximately 30% of the first year =-=[14]-=-. To some extent, differences in scope and scale may also confound these comparisons given the large differences in the operational scale of each programme as well as relative to the context in which ...

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...me settings including PSI’s “Malawi model” that combined traditional social marketing with highly subsidized nets delivered to pregnant women and children under five through ANC-EPI clinics in Malawi =-=[34,35]-=-. Kenya’s mix of ANC distribution, subsidized nets and campaigns has been described elsewhere [26,36-39]. In the Tanzanian “Keep-Up” context combinations of approaches may allow the achievement of LLI...

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...livered through clinics, it means rural areas with few and distant clinics are likely to have low coverage [22,23]. The observation underlines the need to consider new approaches of distributing nets =-=[24,25]-=-. Deliberate programmes, such as social marketing with built-in incentives for health personnel, can be used to increase bed-net coverage in rural areas [26,27], some of which are already in operation...