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Article: Rapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: A systematic synthesis of supply, distribution, and household survey data

TitleRapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: A systematic synthesis of supply, distribution, and household survey data
Authors
Issue Date2010
PublisherPublic Library of Science. The Journal's web site is located at http://medicine.plosjournals.org/perlserv/?request=index-html&issn=1549-1676
Citation
Plos Medicine, 2010, v. 7 n. 8 How to Cite?
AbstractBackground:Development assistance for health (DAH) targeted at malaria has risen exponentially over the last 10 years, with a large fraction of these resources directed toward the distribution of insecticide-treated bed nets (ITNs). Identifying countries that have been successful in scaling up ITN coverage and understanding the role of DAH is critical for making progress in countries where coverage remains low. Sparse and inconsistent sources of data have prevented robust estimates of the coverage of ITNs over time. Methods and Principal Findings:We combined data from manufacturer reports of ITN deliveries to countries, National Malaria Control Program (NMCP) reports of ITNs distributed to health facilities and operational partners, and household survey data using Bayesian inference on a deterministic compartmental model of ITN distribution. For 44 countries in Africa, we calculated (1) ITN ownership coverage, defined as the proportion of households that own at least one ITN, and (2) ITN use in children under 5 coverage, defined as the proportion of children under the age of 5 years who slept under an ITN. Using regression, we examined the relationship between cumulative DAH targeted at malaria between 2000 and 2008 and the change in national-level ITN coverage over the same time period. In 1999, assuming that all ITNs are owned and used in populations at risk of malaria, mean coverage of ITN ownership and use in children under 5 among populations at risk of malaria were 2.2% and 1.5%, respectively, and were uniformly low across all 44 countries. In 2003, coverage of ITN ownership and use in children under 5 was 5.1% (95% uncertainty interval 4.6% to 5.7%) and 3.7% (2.9% to 4.9%); in 2006 it was 17.5% (16.4% to 18.8%) and 12.9% (10.8% to 15.4%); and by 2008 it was 32.8% (31.4% to 34.4%) and 26.6% (22.3% to 30.9%), respectively. In 2008, four countries had ITN ownership coverage of 80% or greater; six countries were between 60% and 80%; nine countries were between 40% and 60%; 12 countries were between 20% and 40%; and 13 countries had coverage below 20%. Excluding four outlier countries, each US$1 per capita in malaria DAH was associated with a significant increase in ITN household coverage and ITN use in children under 5 coverage of 5.3 percentage points (3.7 to 6.9) and 4.6 percentage points (2.5 to 6.7), respectively. Conclusions:Rapid increases in ITN coverage have occurred in some of the poorest countries, but coverage remains low in large populations at risk. DAH targeted at malaria can lead to improvements in ITN coverage; inadequate financing may be a reason for lack of progress in some countries. © 2010 Flaxman et al.
Persistent Identifierhttp://hdl.handle.net/10722/135568
ISSN
2011 Impact Factor: 16.269
2015 SCImago Journal Rankings: 5.667
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Bill & Melinda Gates Foundation
Funding Information:

This study was funded by the Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References

 

DC FieldValueLanguage
dc.contributor.authorFlaxman, ADen_HK
dc.contributor.authorFullman, Nen_HK
dc.contributor.authorOtten Jr, MWen_HK
dc.contributor.authorMenon, Men_HK
dc.contributor.authorCibulskis, REen_HK
dc.contributor.authorNg, Men_HK
dc.contributor.authorMurray, CJLen_HK
dc.contributor.authorLim, SSen_HK
dc.date.accessioned2011-07-27T01:37:19Z-
dc.date.available2011-07-27T01:37:19Z-
dc.date.issued2010en_HK
dc.identifier.citationPlos Medicine, 2010, v. 7 n. 8en_HK
dc.identifier.issn1549-1277en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135568-
dc.description.abstractBackground:Development assistance for health (DAH) targeted at malaria has risen exponentially over the last 10 years, with a large fraction of these resources directed toward the distribution of insecticide-treated bed nets (ITNs). Identifying countries that have been successful in scaling up ITN coverage and understanding the role of DAH is critical for making progress in countries where coverage remains low. Sparse and inconsistent sources of data have prevented robust estimates of the coverage of ITNs over time. Methods and Principal Findings:We combined data from manufacturer reports of ITN deliveries to countries, National Malaria Control Program (NMCP) reports of ITNs distributed to health facilities and operational partners, and household survey data using Bayesian inference on a deterministic compartmental model of ITN distribution. For 44 countries in Africa, we calculated (1) ITN ownership coverage, defined as the proportion of households that own at least one ITN, and (2) ITN use in children under 5 coverage, defined as the proportion of children under the age of 5 years who slept under an ITN. Using regression, we examined the relationship between cumulative DAH targeted at malaria between 2000 and 2008 and the change in national-level ITN coverage over the same time period. In 1999, assuming that all ITNs are owned and used in populations at risk of malaria, mean coverage of ITN ownership and use in children under 5 among populations at risk of malaria were 2.2% and 1.5%, respectively, and were uniformly low across all 44 countries. In 2003, coverage of ITN ownership and use in children under 5 was 5.1% (95% uncertainty interval 4.6% to 5.7%) and 3.7% (2.9% to 4.9%); in 2006 it was 17.5% (16.4% to 18.8%) and 12.9% (10.8% to 15.4%); and by 2008 it was 32.8% (31.4% to 34.4%) and 26.6% (22.3% to 30.9%), respectively. In 2008, four countries had ITN ownership coverage of 80% or greater; six countries were between 60% and 80%; nine countries were between 40% and 60%; 12 countries were between 20% and 40%; and 13 countries had coverage below 20%. Excluding four outlier countries, each US$1 per capita in malaria DAH was associated with a significant increase in ITN household coverage and ITN use in children under 5 coverage of 5.3 percentage points (3.7 to 6.9) and 4.6 percentage points (2.5 to 6.7), respectively. Conclusions:Rapid increases in ITN coverage have occurred in some of the poorest countries, but coverage remains low in large populations at risk. DAH targeted at malaria can lead to improvements in ITN coverage; inadequate financing may be a reason for lack of progress in some countries. © 2010 Flaxman et al.en_HK
dc.languageengen_US
dc.publisherPublic Library of Science. The Journal's web site is located at http://medicine.plosjournals.org/perlserv/?request=index-html&issn=1549-1676en_HK
dc.relation.ispartofPLoS Medicineen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshData Collection - methods-
dc.subject.meshDelivery of Health Care - economics - trends-
dc.subject.meshInsecticide-Treated Bednets-
dc.subject.meshMalaria - economics - epidemiology - prevention and control-
dc.subject.meshMosquito Control - economics - instrumentation - trends-
dc.titleRapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: A systematic synthesis of supply, distribution, and household survey dataen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1549-1277&volume=7&issue=8, article no. e000328&spage=e1000328&epage=1&date=2010&atitle=Rapid+scaling+up+of+insecticide-treated+bed+net+coverage+in+Africa+and+its+relationship+with+development+assistance+for+health:+a+systematic+synthesis+of+supply,+distribution,+and+household+survey+data-
dc.identifier.emailNg, M: marieng@hku.hken_HK
dc.identifier.authorityNg, M=rp01451en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pmed.1000328en_HK
dc.identifier.pmid20808957-
dc.identifier.pmcidPMC2923089-
dc.identifier.scopuseid_2-s2.0-77956824832en_HK
dc.identifier.hkuros186131en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77956824832&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume7en_HK
dc.identifier.issue8en_HK
dc.identifier.spagee1000328-1en_US
dc.identifier.epagee1000328-17en_US
dc.identifier.isiWOS:000281456500012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFlaxman, AD=6602883567en_HK
dc.identifier.scopusauthoridFullman, N=35332224000en_HK
dc.identifier.scopusauthoridOtten Jr, MW=7006396685en_HK
dc.identifier.scopusauthoridMenon, M=16025115900en_HK
dc.identifier.scopusauthoridCibulskis, RE=6603580747en_HK
dc.identifier.scopusauthoridNg, M=36155754200en_HK
dc.identifier.scopusauthoridMurray, CJL=7402491787en_HK
dc.identifier.scopusauthoridLim, SS=7404081544en_HK

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