Costs and effects of the Tanzanian national voucher scheme for insecticide-treated nets
Costs and effects of the Tanzanian national voucher scheme for insecticide-treated nets
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DOI：
10.1186/1475-2875-7-32
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发表时间：
2008-02-15
期刊：
影响因子：
3
通讯作者：
Hanson, Kara
中科院分区：
文献类型：
--
作者：
Mulligan, Jo-Ann;Yukich, Joshua;Hanson, Kara
背景：经杀虫剂处理的蚊帐在降低发病率和死亡率方面的成本效益已得到公认。国际焦点现已转移到如何最好地扩大覆盖范围以及可以使用哪些融资机制来实现这一目标。坦桑尼亚的做法是向最易受疟疾影响的人提供有针对性的补贴，同时为发展商业化驱虫蚊帐分发系统提供支助。2004年10月，在全球抗击艾滋病、结核病和疟疾基金的资助下，政府启动了坦桑尼亚国家驱虫蚊帐计划，这是一个全国性的孕妇及其婴儿驱虫蚊帐折扣券计划。本文分析了该计划的成本和效果，并将其与其他方法distribution.Methods：经济成本估计使用成分的方法，即在提供干预（包括用户贡献）所需的所有资源进行量化和估值。效果的衡量是根据所使用的凭单数量（因此也是蚊帐的交付数量）和蚊帐处理年数。结果和结论：该方案的总财务费用约占卫生部总预算的5%。使用代用券计划提供驱虫蚊帐的平均经济成本，包括使用者的捐款，为7.57美元。成本效益结果在其他疟疾预防研究设定的基准范围内。坦桑尼亚政府推广驱虫蚊帐的办法利用了公共和私营部门，以达到并保持达到阿布贾目标所需的覆盖率。这里所介绍的结果表明，TNVS是向目标弱势群体提供有补贴的驱虫蚊帐的一项具有成本效益的战略。
Background: The cost-effectiveness of insecticide-treated nets (ITNs) in reducing morbidity and mortality is well established. International focus has now moved on to how best to scale up coverage and what financing mechanisms might be used to achieve this. The approach in Tanzania has been to deliver a targeted subsidy for those most vulnerable to the effects of malaria while at the same time providing support to the development of the commercial ITN distribution system. In October 2004, with funds from the Global Fund to Fight AIDS Tuberculosis and Malaria, the government launched the Tanzania National Voucher Scheme (TNVS), a nationwide discounted voucher scheme for ITNs for pregnant women and their infants. This paper analyses the costs and effects of the scheme and compares it with other approaches to distribution.Methods: Economic costs were estimated using the ingredients approach whereby all resources required in the delivery of the intervention (including the user contribution) are quantified and valued. Effects were measured in terms of number of vouchers used (and therefore nets delivered) and treated nets years. Estimates were also made for the cost per malaria case and death averted.Results and Conclusion: The total financial cost of the programme represents around 5% of the Ministry of Health's total budget. The average economic cost of delivering an ITN using the voucher scheme, including the user contribution, was $7.57. The cost-effectiveness results are within the benchmarks set by other malaria prevention studies. The Government of Tanzania's approach to scaling up ITNs uses both the public and private sectors in order to achieve and sustain the level of coverage required to meet the Abuja targets. The results presented here suggest that the TNVS is a cost-effective strategy for delivering subsidized ITNs to targeted vulnerable groups.