Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey

<p>Abstract</p> <p>Background</p> <p>In Tanzania, the distribution and coverage of insecticide-treated nets (ITNs) is inequitable. Arguments about the most effective and equitable approach to distributing ITNs centre around whether to provide ITNs free of charge or cont...

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Main Authors: Mujinja Phares GM, Ruhago George M, Norheim Ole F
Format: Article
Language:English
Published: BMC 2011-07-01
Series:International Journal for Equity in Health
Online Access:http://www.equityhealthj.com/content/10/1/29
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author Mujinja Phares GM
Ruhago George M
Norheim Ole F
author_facet Mujinja Phares GM
Ruhago George M
Norheim Ole F
author_sort Mujinja Phares GM
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>In Tanzania, the distribution and coverage of insecticide-treated nets (ITNs) is inequitable. Arguments about the most effective and equitable approach to distributing ITNs centre around whether to provide ITNs free of charge or continue with existing social marketing strategies. The Government has decided to provide free ITNs to all children under five in the country. It is still uncertain whether this strategy will achieve equitable coverage and use. This study examined the equity implications of ownership and use of ITNs in households from different socioeconomic quintiles in a district with free ITNs and a district without free ITN distribution.</p> <p>Methods</p> <p>A cross-sectional comparative household survey was conducted in two districts: Mpanda in Rukwa Region (with free ITN roll out) and Kisarawe in Coast region (without free ITNs). Heads of 314 households were interviewed in Mpanda and Kisarawe. The concentration index was estimated and regression analysis was performed to compare socioeconomic inequalities in ownership and use of ITNs.</p> <p>Results</p> <p>Ownership of ITNs increased from 29% in the 2007/08 national survey to 90% after the roll out of free ITNs in Mpanda, and use increased from 13% to 77%. Inequality was considerably lower in Mpanda, with nearly perfect equality in use (concentration index 0.009) and ownership (concentration index 0.010). In Kisarawe, ownership of ITNs increased from 48% in the 2007/08 national survey to 53%, with a marked inequality concentration index 0.132. ITN use in Kisarawe district was 42% with a pro rich concentration index of 0.027.</p> <p>Conclusions</p> <p>The results shed some light on the possibilities of reducing inequality in ownership and use of ITNs and attaining Roll Back Malaria and Millennium Development Goals through the provision of free ITNs to all. This has the potential to decrease the burden of disease and reduce disparity in disease outcome.</p>
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spelling doaj.art-5220c82a1a014eadb36357f79434d0972022-12-22T02:46:04ZengBMCInternational Journal for Equity in Health1475-92762011-07-011012910.1186/1475-9276-10-29Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household surveyMujinja Phares GMRuhago George MNorheim Ole F<p>Abstract</p> <p>Background</p> <p>In Tanzania, the distribution and coverage of insecticide-treated nets (ITNs) is inequitable. Arguments about the most effective and equitable approach to distributing ITNs centre around whether to provide ITNs free of charge or continue with existing social marketing strategies. The Government has decided to provide free ITNs to all children under five in the country. It is still uncertain whether this strategy will achieve equitable coverage and use. This study examined the equity implications of ownership and use of ITNs in households from different socioeconomic quintiles in a district with free ITNs and a district without free ITN distribution.</p> <p>Methods</p> <p>A cross-sectional comparative household survey was conducted in two districts: Mpanda in Rukwa Region (with free ITN roll out) and Kisarawe in Coast region (without free ITNs). Heads of 314 households were interviewed in Mpanda and Kisarawe. The concentration index was estimated and regression analysis was performed to compare socioeconomic inequalities in ownership and use of ITNs.</p> <p>Results</p> <p>Ownership of ITNs increased from 29% in the 2007/08 national survey to 90% after the roll out of free ITNs in Mpanda, and use increased from 13% to 77%. Inequality was considerably lower in Mpanda, with nearly perfect equality in use (concentration index 0.009) and ownership (concentration index 0.010). In Kisarawe, ownership of ITNs increased from 48% in the 2007/08 national survey to 53%, with a marked inequality concentration index 0.132. ITN use in Kisarawe district was 42% with a pro rich concentration index of 0.027.</p> <p>Conclusions</p> <p>The results shed some light on the possibilities of reducing inequality in ownership and use of ITNs and attaining Roll Back Malaria and Millennium Development Goals through the provision of free ITNs to all. This has the potential to decrease the burden of disease and reduce disparity in disease outcome.</p>http://www.equityhealthj.com/content/10/1/29
spellingShingle Mujinja Phares GM
Ruhago George M
Norheim Ole F
Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey
International Journal for Equity in Health
title Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey
title_full Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey
title_fullStr Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey
title_full_unstemmed Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey
title_short Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey
title_sort equity implications of coverage and use of insecticide treated nets distributed for free or with co payment in two districts in tanzania a cross sectional comparative household survey
url http://www.equityhealthj.com/content/10/1/29
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