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Table 1 Summary of studies that provide cost estimates of the delivery of insecticide and/or nets

From: Costing the distribution of insecticide-treated nets: a review of cost and cost-effectiveness studies to provide guidance on standardization of costing methodology

Category* Distribution Study** Country Perspective Cost included Guideline used*** Year of price Currency Cost**** Source
Financial Economic Per net delivered Per treatment delivered Per ITN delivered Per treated net year Per person protected
Public/Public Campaign (Door-to-door) C Solomon Islands (Florida Islands) Provider Nets, insecticide, transport, fuel, repairs, wages, equipment, materials, facilities Time taken Yes 1988/89 SI$      3.85 (= US$ 1.97) 341
  Campaign (Door-to-door) C China (Napo County) Provider Insecticide   No 1990 – 92 Yuan      0.48F 35
  Campaign (Door-to-door) CE Northern Ghana (Kassena – Nankana district) Provider Nets, insecticide, wages, transport, supplies & services Adjusted financial costs plus time of volunteers Yes 1993/94 US$ (and Cedis)    2.40    20
  General health facilities CE The Gambia Provider Nets, insecticide, etc. (taken from Picard et al. 1993) Adjusted financial costs No 1990 US$    6.24    36
  Campaign (Door-to-door) C Tanzania Provider Nets, insecticide, wages, transport Cost of nets was annualised (but not discounted) No 1996 US$ 1.00F 0.46F 1.46F    37
  Campaign (Distrib. point not specified; assumed central) CE Thailand (Thai-Myanmar Border) Patients Direct medical costs, transportation, food Time absent from work Yes 1994/95 US$       38
  Campaign (Door-to-door) C Pakistan (Afghan refugee camps) Provider Net, insecticide, operational costs Cost of net annualised (but not discounted) No 1991 – 94 US$      1.51 39
  Campaign (Fixed-site) CE South Africa (KwaZulu-Natal) Provider Nets, insecticide, wages, equipment, transport, storage space Adjusted financial cost plus donated insecticide Yes 1999 US$ (and Rand)      3.82 40
  Campaign (Distrib. point not specified; assumed to be central) CE Thailand (Thai-Myanmar border) Provider Wages, material, capital cost   Yes 1994 US$      1.30F 41
  Antenatal Clinics C Kenya Provider Net and insecticide, transport   No 2001 US$    3.81F 5.26F, L    19
Public/Public Campaign (Door-to-door) C Columbia Provider Wages, per diems, insecticide, transport   Yes 2001 US$   5.10F (near) 12.40F (far)     42
  Campaign (Fixed-site) C Tropical Africa Provider Nets, wages, allowances, transport   Yes 2003 US$ 2.40F      22
  Campaign (Fixed-site) CE Kenya Society Insecticide, nets, wages, supplies, transport, buildings, equipment, furniture, water, time of users Adjusted financial costs plus value of community labour Yes 1996 US$    1.90NC 2.20N   1.4NC 1.6N 4
  Measles vaccination sites C Ghana Provider ITNs, training and supervision, transportation, community education   No 2002 US$    3.74F    43
Public/Mixed Campaign – fixed site (Field trial using PHC workers & villagers) CE The Gambia Society Insecticide, wages, transport, equipment, treatment, funeral expenses Adjusted financial costs plus time of volunteers, carers, hours lost due to mourning Yes 1990 US$   5.65     44
  Local clinics Mobile teams CHW C Afghanistan Provider Nets, insecticide, monitoring, supervision, training, clinic overheads, wages, transport Cost per net was adjusted (but not of other capital items) Yes 1995 US$ 2.01 1.89 1.08 0.49 1.87     45
  Campaign (Door-to-door) CE The Gambia (National Programme) Society (Provider + Community) Insecticide, wages, supplies, services, transport, equipment, awareness campaign, community capital costs incl. nets Adjusted financial costs plus community time and water Yes 1991 – 92 US$ (and Dalasis)   1.00N 3.30N    26
  Campaign (Fixed site) C Vietnam (Hoa Binh Province) Provider Insecticide, equipment, labour, nets and transport (purchased by community) Adjusted financial costs Yes 1996 US$ 0.58 – 0.61P 0.32P    0.90 – 0.93 31
Mixed/Mixed Public and private sales agents C Tanzania Project costs and users' contributions    No 1998 – 99 US$ 6.14 – 6.87F 1.72 – 2.11F     46
  Public and private sales agents CE Tanzania Project implementation costs, user contributions, travel costs Adjusted financial costs plus time of users, in-kind community contributions, donated inputs Yes 2000 US$ (and Shillings)     8.30F 13.38   5
  General health facilities & commercial outlets CE Malawi Provider Capital and recurrent costs Adjusted capital costs (assumed life-span as in Hanson et al. 2003) Yes 1998 – 2003 US$    2.63 4.41   27
Private/Mixed Community (Community groups) C, CE Kenya (Western highlands) Provider & Society Wages, nets, insecticide, cost-recovery included and excluded in analysis Adjusted financial costs plus opportunity cost of MoH Government, community, and of using NGO truck Yes 2000 US$ (and Shillings)    4.68 30.00O    47,48
Private/Private Community C Benin (Savalou region) Provider Local mosquito net production, insecticide, transportation, wages   No 1993 US$ (and CFA)    10.50F(sales price incl. profit)    49
  Community (Community groups) C Kenya Provider Nets, netting material, insecticide, project running cost, monitoring, awareness campaign, training, transport Some financial costs adjusted (but nets not included as capital items) No 2002 US$    15.80F 14.40    9
  Formal sector retail outlet C The Gambia Provider Net (locally made), insecticide Cost of net annualised but not discounted No 1987 US$ 1.75 0.30 2.05    50
  1. * Delivery Point/Financing of net & insecticide (Public = Free, Mixed = Partially Subsidised, Private = Full Cost and includes payment by households)
  2. ** C = Study providing cost estimate; CE = Study carried out to establish cost-effectiveness
  3. *** Guidelines include reference by the authors to relevant documents for guidance on costing
  4. **** Economic cost is provided unless otherwise indicated (economic costs are derived from financial costs by excluding VAT, annualising capital costs and annualising programme development costs over expected useful life of net)
  5. C Community effect included; also called 'mass effect', see reference 51 and 52 for examples
  6. F Financial cost, rather than economic cost
  7. I Incremental cost over two year study period
  8. L Cost including leakage to non-target group
  9. N Net cost, i.e. total implementation cost minus resources saved
  10. O Cost estimate including overheads to support the NGO facilitating the ITN programme
  11. P Average cost per person protected, not per net; generally nets were single or double size
  12. 1 see reference 23 for price in US$
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Malaria Journal

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