Ability and willingness to pay for insecticide treated nets in Meteitei location, South Nandi District

Abstract

Malaria remains today one of the major health problems in the tropics and continues to be the cause of high morbidity and mortality despite the various preventive measures against it. It is estimated that there are 3000 deaths every day globally, with 90% of these occurring in the sub-Saharan Africa. The purpose of the study was to find out the factors responsible for the low ITN coverage in Kenya (5-10%). The objectives of the study were: to determine the prevalence of utilization of ITNs; to determine the characteristics of users of ITNs and to assess community's ability and willingness to pay for ITNs. A cross sectional survey was carried out in Meteitei location in South Nandi District through multistage, purposive, cluster and stratified sampling methods. Data was collected using a pre-tested interviewer administered questionnaire. The key variables included socio demographic, socioeconomic data and prevalence of ITNs use. The properties owned, type of housing, donations per month and monthly income were used to assess the ability to pay for ITNs. Contingent valuation method was used in assessing the willingness to pay for ITNs. Data was analysed with SPSS for frequencies,cross tabulation and Chi square test; statistical significance set at P<0.05. Data was collected from 374 respondents which included 212 (56 .7%) males and 162(43.3%) females. Their ages ranged from 18 years to 89 years with a mean of 40.32 years and median of 38 years. Most were married 308 (82.4%) and only a few 56 (15%) had never gone to school at all. The majority (70.6%) were unemployed and only 22.2% were skilled workers. Only 18 (4.5%) had a motorcycle Posho mill, tractor or a lorry or a solar panel. Nearly all respondents 345 (92.2%) reported having heard of the ITNs, however ITN use was reported by only 33.1%. There was a significant relationship between having electricity in the house and having an ITN (p=O.009).The study found having a bed was a determinant of having an ITN. A strong relationship between the amount of money spent on donations and having an !TN was also established (p=O.005). Similarly, the relationship between the type of house and having an ITN was statistically significant (p=0.00). The majority of the respondents 176(47.6%) were willing to pay 50/= using contingent valuation method, howeverthere was no significant relationship between the respondents' WTP for ITN at 300/=and their abilityto pay for them (p=0.57). The presence of a bed was found to be an indicator of availability of an ITN. The prevalenceof ITN use of 33.1% though still higher than in most other studies done, it is still far below the target of 20% by the year 2006 as proposed in the Abuja Declaration. Although many people were willing to purchase the nets at a relatively low price, accessibil itywas identified as a problem. The study concluded that it is vital that public policies and financing mechanisms are put in place to protect the poor from cost-sharing arrangements and to ensure that they derive equal benefit from the use of ITNs. It is recommended that ITN coverage should be increased, and poverty alleviation programmes should be adopted by the government and its partners in malaria control.