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Abstract Building on nonexperimental literature on the economic impact of malaria, this paper evaluates the commercial impact of a private sector malaria control project in Zambia’s cotton industry. Using a cluster randomized trial involving 81,597 smallholder cotton farmers in 1,507 clusters, I evaluate whether the distribution of free insecticide-treated mosquito nets at the outset of malaria season increased farmer’s cotton production sufficiently to be commercially viable for the implementing agribusiness. But despite large health effects, I do not detect any impact on cotton deliveries to the business. I conclude that the independent and sustained distribution of free bed nets by Zambia’s cotton industry is unlikely to materialize without subsidies. More generally, the results question widespread narratives about the economic impact of malaria control, as well as the ability of standard economic models to explain the labor decisions of smallholder farmers. The study evaluates whether the sourcing of insecticide-treated nets and their distribution to smallholder farmers for free would be a profitable investment for a cotton outgrowing agribusiness in Zambia.
Last Published November 22, 2013 12:20 PM November 23, 2013 02:22 PM
Study Withdrawn No
Intervention Completion Date December 28, 2011
Data Collection Complete Yes
Final Sample Size: Number of Clusters (Unit of Randomization) 1507
Was attrition correlated with treatment status? No
Final Sample Size: Total Number of Observations 81472
Final Sample Size (or Number of Clusters) by Treatment Arms 739 T, 768 C
Do all standard errors account for clustering? Yes
Data Collection Completion Date December 01, 2012
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Papers

Field Before After
Paper Abstract PRIVATE SECTOR PERSPECTIVE (DUNAVANT): ECONOMIC EFFECTS Building on nonexperimental literature on the economic impact of malaria, this paper evaluates the commercial impact of a private sector malaria control project in Zambia’s cotton industry. Using a cluster randomized trial involving 81,597 smallholder cotton farmers in 1,507 clusters, I evaluate whether the distribution of free insecticide-treated mosquito nets at the outset of malaria season increased farmer’s cotton production sufficiently to be commercially viable for the implementing agribusiness. But despite large health effects, I do not detect any impact on cotton deliveries to the business. I conclude that the independent and sustained distribution of free bed nets by Zambia’s cotton industry is unlikely to materialize without subsidies. More generally, the results question widespread narratives about the economic impact of malaria control, as well as the ability of standard economic models to explain the labor decisions of smallholder farmers.
Paper Citation Sedlmayr, Richard, On the Economic Impact of Malaria Control, Some Discordant Evidence (November 21, 2013). Available at SSRN: http://ssrn.com/abstract=2358045
Paper URL http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2358045
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Field Before After
Paper Abstract PUBLIC SECTOR PERSPECTIVE (NMCP): HEALTH EFFECTS The distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia’s NMCP.
Paper Citation Sedlmayr, R., Fink, G., Miller, J. M., Earle, D., & Steketee, R. W. (2013). Health impact and cost-effectiveness of a private sector bed net distribution: experimental evidence from Zambia. Malaria Journal, 12:102 .
Paper URL http://www.malariajournal.com/content/12/1/102
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