Regarding the availability of nets, nets are definitely available to purchase, even in places that have universal distribution of bednets. It’s not how most people get their nets though; the majority of households in Uganda, Guinea, Nigeria, and Togo (for example) got their nets from mass distributions. To hypothesize some reasons why one might buy nets even in the case of universal distribution — it might be to get more nets per household, nets of a larger size, nets for a new child, etc. In general I think we expect people buying nets to live in richer and less remote areas, which are at less risk of malaria.
Some of the most remote areas (think places which are only reachable by boat, or only seasonally, for example) might not have bednets available for purchase, or at least not all the time. These areas tend to be poorer and at higher risk for malaria, but also harder to study (and harder to reach by bednet distribution programs). I’m not aware of any study that looks at such remote areas specifically.
Regarding the cost of bednets, their purchase is extremely cost-elastic. Cohen and Dupas write “We find that uptake drops by 60 percentage points when the price of ITNs increases from zero to $0.60 (i.e. from 100 to 90 percent subsidy), a price still $0.15 below the price at which ITNs are currently sold to pregnant women in Kenya.” The total cost to buy and distribute AMF nets is $4 to $6 and as far as I’m aware the unsubsidized retail price is not far off from that. As I recall, Living Good suggests a price of 600 Kenyan shillings (about $4 US) for a bed net. In Uganda, for example, the median income is $804 per year, so we’re talking about close to 0.5% of annual income per net (keeping in mind that those who actually buy nets on the private market are richer than this).
Does this answer your question? I’m not really sure where the cruxes are but I’m happy to help.
Regarding the availability of nets, nets are definitely available to purchase, even in places that have universal distribution of bednets. It’s not how most people get their nets though; the majority of households in Uganda, Guinea, Nigeria, and Togo (for example) got their nets from mass distributions. To hypothesize some reasons why one might buy nets even in the case of universal distribution — it might be to get more nets per household, nets of a larger size, nets for a new child, etc. In general I think we expect people buying nets to live in richer and less remote areas, which are at less risk of malaria.
Some of the most remote areas (think places which are only reachable by boat, or only seasonally, for example) might not have bednets available for purchase, or at least not all the time. These areas tend to be poorer and at higher risk for malaria, but also harder to study (and harder to reach by bednet distribution programs). I’m not aware of any study that looks at such remote areas specifically.
Regarding the cost of bednets, their purchase is extremely cost-elastic. Cohen and Dupas write “We find that uptake drops by 60 percentage points when the price of ITNs increases from zero to $0.60 (i.e. from 100 to 90 percent subsidy), a price still $0.15 below the price at which ITNs are currently sold to pregnant women in Kenya.” The total cost to buy and distribute AMF nets is $4 to $6 and as far as I’m aware the unsubsidized retail price is not far off from that. As I recall, Living Good suggests a price of 600 Kenyan shillings (about $4 US) for a bed net. In Uganda, for example, the median income is $804 per year, so we’re talking about close to 0.5% of annual income per net (keeping in mind that those who actually buy nets on the private market are richer than this).
Does this answer your question? I’m not really sure where the cruxes are but I’m happy to help.
This does answer the question and is much appreciated! Do you have any sources I can cite (other than the paper linked in your response) ?
I can try to scare up some sources, but do you mind if I ask if there are particular claims that you are especially interested in?