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Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008

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  • Yoko Akachi
  • Rifat Atun

Abstract

Background: Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. Methods and Findings: We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery/intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002–2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets (ITNs)/indoor residual spraying (IRS). As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance (ODA) for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774–63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369–0.881]. Cumulatively Global Fund investments that increased ITN/IRS coverage in 2002–2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries ($3.90 vs. $7.05). Increased ITN/IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN/IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN/IRS would reduce 1.5 [95%CI: 0.3–2.8] child deaths per 1000 live births. Conclusions: Along with other key child survival interventions, increased ITNs/IRS coverage has significantly contributed to child mortality reduction since 2002. ITN/IRS scale-up can be more efficiently prioritized to countries where malaria is a major cause of child deaths to save greater number of lives with available resources.

Suggested Citation

  • Yoko Akachi & Rifat Atun, 2011. "Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0021309
    DOI: 10.1371/journal.pone.0021309
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    2. Sory Toure & David Lopez-Carr & John Weeks & Douglas Stow, 2020. "Evaluating links between dynamic urban landscapes and under-five child mortality in Accra, Ghana," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 42(20), pages 589-614.

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