Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008.
BACKGROUND: Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. METHODS...
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| Format: | Article |
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Public Library of Science (PLoS)
2011-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3127861?pdf=render |
| _version_ | 1818299619264692224 |
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| author | Yoko Akachi Rifat Atun |
| author_facet | Yoko Akachi Rifat Atun |
| author_sort | Yoko Akachi |
| collection | DOAJ |
| description | BACKGROUND: Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. METHODS AND FINDINGS: We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery/intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002-2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets (ITNs)/indoor residual spraying (IRS). As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance (ODA) for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774-63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369-0.881]. Cumulatively Global Fund investments that increased ITN/IRS coverage in 2002-2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries ($3.90 vs. $7.05). Increased ITN/IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN/IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN/IRS would reduce 1.5 [95%CI: 0.3-2.8] child deaths per 1000 live births. CONCLUSIONS: Along with other key child survival interventions, increased ITNs/IRS coverage has significantly contributed to child mortality reduction since 2002. ITN/IRS scale-up can be more efficiently prioritized to countries where malaria is a major cause of child deaths to save greater number of lives with available resources. |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T04:54:06Z |
| publishDate | 2011-01-01 |
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| series | PLoS ONE |
| spelling | doaj.art-eecd07591719441eaba9ef83c31ec9f72022-12-21T23:58:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-0166e2130910.1371/journal.pone.0021309Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008.Yoko AkachiRifat AtunBACKGROUND: Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. METHODS AND FINDINGS: We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery/intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002-2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets (ITNs)/indoor residual spraying (IRS). As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance (ODA) for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774-63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369-0.881]. Cumulatively Global Fund investments that increased ITN/IRS coverage in 2002-2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries ($3.90 vs. $7.05). Increased ITN/IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN/IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN/IRS would reduce 1.5 [95%CI: 0.3-2.8] child deaths per 1000 live births. CONCLUSIONS: Along with other key child survival interventions, increased ITNs/IRS coverage has significantly contributed to child mortality reduction since 2002. ITN/IRS scale-up can be more efficiently prioritized to countries where malaria is a major cause of child deaths to save greater number of lives with available resources.http://europepmc.org/articles/PMC3127861?pdf=render |
| spellingShingle | Yoko Akachi Rifat Atun Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008. PLoS ONE |
| title | Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008. |
| title_full | Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008. |
| title_fullStr | Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008. |
| title_full_unstemmed | Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008. |
| title_short | Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008. |
| title_sort | effect of investment in malaria control on child mortality in sub saharan africa in 2002 2008 |
| url | http://europepmc.org/articles/PMC3127861?pdf=render |
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