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[DAR es SALAAM] Demand and willingness to buy insecticide-treated nets (ITNs) could increase coverage in malaria-endemic areas in Tanzania, a study suggests.
Researchers from Tanzania and the United States say that it is challenging to achieve the WHO recommendation of every two household members having a bed net in regions where malaria transmission is high, and thus factors that impact demand for ITNs should be explored.

According to the National Malaria Control Programme in Tanzania, 90 per cent of the population live in areas with a high risk of malaria transmission.
 In the study published last month (14 July) in the Malaria Journal, researchers conducted discrete choice experiment, an approach that involves asking participants to identify which products they prefer when presented with two or more options at fixed prices.

The researchers presented participants from the Ruvuma and Mwanza regions of Tanzania with seven scenarios of ITNs with characteristics such as bed net size, shape and insecticide treatment, and asked each to select which one they would prefer to buy with a stipend of 10,000 Tanzanian shillings (about US$4).

“If people are given a chance to buy, the [bed] net coverage and use should increase, thereby reducing malaria incidence.”

Chris Gingrich, Eastern Mennonite University


“Nearly 800 participants sampled in two regions showed an overall strong demand for nets, with 40 per cent choosing to buy a net across all seven combinations of net prices and characteristics such as size, shape, and insecticide treatment,” the researchers note in the Malaria Journal. “Only eight per cent of all participants chose not to buy a single net. Both poor and less poor households showed strong evidence of making purchase decisions based on more than price alone.”  
Chris Gingrich, a co-author and an economics professor at the US-based Eastern Mennonite University, says that free distribution of ITNs should no longer be the sole means of ensuring the coverage.
“If people are given a chance to buy, the [bed] net coverage and use should increase, thereby reducing malaria incidence,” Gingrich explains.
Amos Kahwa, a co-author and a senior research scientist at the National Institute for Medical Research, Tanzania, says the selection of study regions was strategic.
 “These regions had been recently involved in bed net programmes under the national subsidised voucher scheme for pregnant women and infants,” he tells SciDev.Net.
“Our assumption was that people would show little interest in buying additional nets.  
 “There are people who were given free bed nets [in the past] and they chose to use them for other purposes such as turning them into fishing nets. There was need to find out whether people value them.’’ But Frederick Haraka, a research scientist at the Ifakara Health Institute, Tanzania, tells SciDev.Net that there is a need for studies that reflect practical demand for buying bed nets.
 “The study sounds logical but I think it needs to be piloted first,” Haraka says, explaining that requiring people to use their income to buy bed nets may help gauge actual demand.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.


Chris D. Gingrich and others Demand and willingness-to-pay for bed nets in Tanzania: results from a choice experiment (Malaria Journal, 14 July 2017)