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APHA Scientific Session and Event Listing

Recorded presentation

Sohail Agha, PhD, International Health and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, (504) 988 - 3655, sagha@tulane.edu

Background An ITN intervention was initiated in 3 districts of Eastern Province, Zambia. These rural districts lacked commercial distribution and communication infrastructures. Social marketing techniques were used for product and message development and public sector clinics and village-based volunteers promoted and distributed subsidized ITNs at a price of $2.5 per net.

Methods A post-test only quasi-experimental study design was used: 3 intervention and 2 comparison districts were compared on a survey that was implemented two years after the intervention was initiated. A total of 2,986 respondents were interviewed. Survey respondents were grouped into 4 SES categories: low, medium-low, medium and high. Knowledge, access and use indicators are compared between intervention and comparison districts. Concentration index scores are calculated and compared between intervention and comparison districts. Interactions between intervention status and SES help determine how different SES groups benefit from the intervention.

Results The intervention was associated with improved knowledge, access and use indicators and declines in SES inequities in the use of ITNs. These declines were driven primarily by improvements among medium-low and medium SES categories. The price of nets remained an important barrier to purchase and use of nets.

Policy Implications Extreme poverty among the lowest SES groups in rural areas may make it difficult for households to pay for social marketing supplied nets. Free distribution may be more effective in reaching the poorest individuals in rural Africa. Social marketing can reduce SES inequities in the use of nets by focusing its efforts on medium-low and medium SES group.

Learning Objectives: By the end of the session, the participants will be able to

• Assess the degree to which a social marketing ITN intervention was able to reach the poor in rural Zambia
• Understand how social marketing ITN interventions may reduce inequity in the use of mosquito nets

Keywords: Rural Health, Access and Services

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation