How can the poor afford insecticide treated bednets to protect them at night from insects carrying malaria? The Wellcome Trust Research Laboratories, Nairobi, together with the Kenyan Ministry of Health, carried out research in rural Kenya to find out if families would be willing and able to pay for the insecticide treated bednets.

Over the next five years the World Health Organisation has proposed a massive 3 000 per cent increase in the use of bednets treated with insecticide. But who will meet the costs? Many of the governments dealing with the burden of malaria do not have the funds to pay for the nets.

The study interviewed 390 families in rural highland Kenya on their willingness to pay for nets, and compared this with current household expenditure in this population.

Researchers found that most families were, in theory, willing to pay for the nets. However, since most of a family’s expenditure is on basic needs, it is unlikely they would be able to afford them. The cost of providing a family with the nets would be the equivalent of sending three children to primary school for a year. Poor rural families who wish to protect themselves with the netting cannot afford to do so.

The study found that:

• 97 per cent of families said they were willing to pay for the treated bednets
• the most frequent amount offered for the nets was 50 Kenyan shillings (46 per cent of responses)
• when they were told that nets cost 350 Kenyan shillings (US$ 4.48), a quarter of the people interviewed were still prepared to pay this price
• poor families had an average income of US$ 42 per month, most of which was spent on food
• not being able to afford the nets was the overwhelming reason for families not to purchase them.

Many families may only manage to pay for nets by buying less food or not sending their children to school. In order to meet the World Health Organisation target and break the cycle of malaria and poverty, it is recommended that bednets be provided free of charge. This would ensure a rapid increase in coverage, without introducing the inequities inherent in charging for nets.

Source(s):
‘Too poor to pay: charging for insecticide-treated bednets in highland Kenya’, Tropical Medicine and International Health 7 (10): 846-850, by H. Guyatt, S. Ochola and R. Snow, 2002
HINARI subscribers can access the full-text article here. Full document.

Funded by: The Wellcome Trust (UK); Kenya Medical Research Institute

id21 Research Highlight: 11 March 2003

Further Information:
Helen Guyatt
Wellcome Trust Research Laboratories/KEMRI
Nairobi
PO Box 43640
Kenya

Contact the contributor: hguyatt@wtnairobi.mimcom.net

Wellcome Trust Research Laboratories, Nairobi, Kenya

Other related links:
Casting the net – free bednets for pregnant Kenyan women

Control panel - tools to prevent malaria epidemics in highland Africa

Insecticide treatment of mosquito nets - the user’s view

See id21's collection of links relevant to infectious diseases.