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. 2016 Nov 21;6(11):e012776.
doi: 10.1136/bmjopen-2016-012776.

Large-scale implementation of disease control programmes: a cost-effectiveness analysis of long-lasting insecticide-treated bed net distribution channels in a malaria-endemic area of western Kenya-a study protocol

Elvis Gama  1 , Vincent Were  1   2 , Peter Ouma  2 , Meghna Desai  3 , Louis Niessen  1 , Ann M Buff  3   4 , Simon Kariuki  2
Affiliations

Large-scale implementation of disease control programmes: a cost-effectiveness analysis of long-lasting insecticide-treated bed net distribution channels in a malaria-endemic area of western Kenya-a study protocol

Elvis Gama et al. BMJ Open. .

Abstract

Introduction: Historically, Kenya has used various distribution models for long-lasting insecticide-treated bed nets (LLINs) with variable results in population coverage. The models presently vary widely in scale, target population and strategy. There is limited information to determine the best combination of distribution models, which will lead to sustained high coverage and are operationally efficient and cost-effective. Standardised cost information is needed in combination with programme effectiveness estimates to judge the efficiency of LLIN distribution models and options for improvement in implementing malaria control programmes. The study aims to address the information gap, estimating distribution cost and the effectiveness of different LLIN distribution models, and comparing them in an economic evaluation.

Methods and analysis: Evaluation of cost and coverage will be determined for 5 different distribution models in Busia County, an area of perennial malaria transmission in western Kenya. Cost data will be collected retrospectively from health facilities, the Ministry of Health, donors and distributors. Programme-effectiveness data, defined as the number of people with access to an LLIN per 1000 population, will be collected through triangulation of data from a nationally representative, cross-sectional malaria survey, a cross-sectional survey administered to a subsample of beneficiaries in Busia County and LLIN distributors' records. Descriptive statistics and regression analysis will be used for the evaluation. A cost-effectiveness analysis will be performed from a health-systems perspective, and cost-effectiveness ratios will be calculated using bootstrapping techniques.

Ethics and dissemination: The study has been evaluated and approved by Kenya Medical Research Institute, Scientific and Ethical Review Unit (SERU number 2997). All participants will provide written informed consent. The findings of this economic evaluation will be disseminated through peer-reviewed publications.

Keywords: Cost analysis; Economic evaluation; Insecticide-treated bed nets; Supply and distribution.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Concept map of economic evaluation of long-lasting insecticide-treated bed nets distribution channels in Busia County, Kenya.
See this image and copyright information in PMC

References

    1. Independent Commission for Aid Impact (ICAI). DFID's Contribution to the Reduction of Child Mortality in Kenya. Report No. 33 London: ICAI, 2014.
    1. World Health Organization (WHO). Recommendations for achieving universal coverage with long-lasting insecticidal nets in malaria control. Geneva: WHO, 2014. http://www.who.int/malaria/publications/atoz/who_recommendations_univers....
    1. U.S. President's Malaria Initiative-Kenya. Malaria Operational Plan FY2015. Washington, DC: U.S. Agency for International Development, 2014. https://www.pmi.gov/docs/default-source/default-document-library/malaria....
    1. UN. The Millennium Development Goals Report New York: United Nations, 2010.
    1. Ministry of Public Health and Sanitation. National Malaria Strategy 2009–2017. Nairobi: Division of Malaria Control, Ministry of Public Health and Sanitation, 2009.

MeSH terms