| Equity trends in ownership of insecticide-treated nets in 19 Sub-Saharan African countries |
| Authors: |
Cameron Taylor, Lia Florey, and Yazoume Ye |
| Source: |
Bulletin of the World Health Organization, 95:322–332; doi: http://dx.doi.org/10.2471/BLT.16.172924 |
| Topic(s): |
Insecticidetreated mosquito nets (ITNs)
|
| Country: |
Africa
Multiple African Countries
|
| Published: |
FEB 2017 |
| Abstract: |
Abstract
Objective To examine the change in equity of insecticide-treated net (ITN) ownership
among 19 malaria endemic countries in sub-Saharan Africa before and after the launch
of the Cover the bed net gap initiative.
Methods To assess change in equity in ownership of at least one ITN by
household from different wealth quintile, we used data from the Demographic and
Health Surveys and Malaria Indicator Surveys. We assigned surveys conducted before
the launch (2003–2008) as baseline surveys and surveys conducted 2009–2014 as
endpoint surveys. We did country-level and pooled multicountry analyses. Pooled
analyses based on malaria transmission risk, were done by dividing geographical zones
into either low- and intermediate-risk or high-risk. To assess changes in equity, we
calculated the Lorenz concentration curve and concentration index (C-index).
Results Out of the 19 countries we assessed, 13 countries showed improved
equity between baseline and endpoint surveys and two countries showed no changes.
Four countries displayed worsened equity, two favouring the poorer households and two
favouring the richer. The multicountry pooled analysis showed an improvement in equity
(baseline survey C-index: 0.11; 95% confidence interval, CI: 0.10 to 0.11; and endpoint
survey C-index: 0.00; 95% CI: -0.01 to 0.00). Similar trends were seen in both low- and
intermediate-risk and high-risk zones.
Conclusion The mass ITN distribution campaigns to increase coverage, linked
to the launch of the Cover the bed net gap initiative, have led to improvement in
coverage of ITN ownership across sub-Saharan Africa with significant reduction in
inequity among wealth quintiles. |
| Web: |
http://www.who.int/bulletin/online_first/BLT.16.172924.pdf?ua=1 |
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