[Question] What are some cost-effective co-interventions (and alternatives) to bednet disbursal?


I am thinking of information on other preventive healthcare measures, demonstrating the importance of using a net at disbursal, and extrapolating the care of sharing a net to consideration of others in general also by officers who distribute nets. For alternatives maybe vaccine development, existing prophylaxis drugs procurement cost reduction agreements or investments, and profit-motivated and extraeconomic self-development opportunities. Can any of this be competitive in cost-effectiveness with the current AMF programming? What else can be cost-effective?

In regards to co-interventions, I am thinking:

Beneficiary health and wellbeing improvement

  • A cool poster/​sheet under the net packaging inspiring people to take other preventive healthcare measures, such as teach children to wash hands, take children to the clinic when they experience difficulty breathing (not COVID but Lower respiratory infections treatment (filtering for Low SDI)), having a childbirth at the clinic (neonatal also the linked GBD compare resource), giving water with sugar and salt when children experience diarrhea, info on HIV/​AIDS prevention, iron supplementation (or reminding millers to fortify their flour or buying just fortified), vitamin A supplementation, vaccination, good locally available and affordable protein sources and their importance, plus maybe something on road safety (such as reminding drivers to not speed and chat with the local authorities if drivers are unsafe) - with information on locally available free of charge services and possibly a small tokens of appreciation (e. g. if available for vaccination/​supplementation)

    • Beneficiaries can enjoy posters as anecdotally a poor or extremely poor farmer in Kenya was decorating their house with random newspapers (described by a former Wall Street Journal correspondent)

  • Also something that would motivate people to really use the nets—the current use rate (based on the limited data available on GW’s page) should be about 75%

    • Maybe coaching the officers who disburse the nets to tell people/​demonstrate (also from the WSJ journalist book) - demonstrating maybe be more effective than just telling because perhaps people learn better from experience—why it is important to use the net (prevention of stress when a child gets malaria and medicine is needed very fast when funding to travel for and purchase medicine may not be available)

  • Something that would motivate people to take care of others

    • Just like giving a net to one’s family, it is important to motivate children to study, not be abusive, and report bullies to local (informal) authorities—ideally by personal example of continued self-development and righteous action—maybe also specified by the officers during disbursal—this should address wellbeing issues related to limited agency and perception of growth prospects

I think that if there is someone who develops shareable training material for the disbursal officers then it should be ok with AMF to allow such training and maybe measure effects by an RCT since they already collect data from all households individually. Similarly with any info sheets but these need to be printed and placed which is a task that requires more coordination effort. It is a potentially high impact opportunity especially for community members in emerging economies.

I think that even funders can enjoy this as always the most cost-effective intervention is sought, ideally one which supports institutional change. Which can inspire funding leverage at funder’s partners and competitors that are also selecting from competing impact opportunities.


Also, what are the alternatives and should they be prioritized at the cost of not disbursing bednets (maybe funding vaccine R&D, negotiating bulk purchase (or free of charge, just like for deworming drugs) agreements with suppliers of malarone and other chemoprophylaxis drugs, stepping back and seeing if people should be rather given actual prospects in terms of employment opportunities and extraeconomic self-development)?

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