Micro-Loans, Insecticide-Treated Bednets and Malaria: Evidence from a Randomized Controlled Trial in Orissa (India)

58 Pages Posted: 10 Jul 2011

See all articles by Alessandro Tarozzi

Alessandro Tarozzi

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Aprajit Mahajan

Stanford University; University of California, Berkeley - Department of Agricultural & Resource Economics; National Bureau of Economic Research (NBER)

Brian Blackburn

affiliation not provided to SSRN

Daniel Kopf

affiliation not provided to SSRN

Lakshmi Krishnan

affiliation not provided to SSRN

Joanne Yoong

RAND Corporation

Date Written: March 9, 2011

Abstract

Many severe health risks in developing countries could be substantially reduced with access to appropriate preventive measures. However, the associated costs are often high enough to restrict access among poor households, and free provision through public health campaigns is often not financially feasible. We describe findings from the first large-scale cluster randomized controlled trial in a developing country context that evaluates the uptake of a health-protecting technology, insecticide-treated bednets (ITNs), through micro-consumer loans, as compared to free distribution and control conditions. Numerous studies have shown that widespread, regular use of ITNs is one the most effective preventive measures against malaria. However, ownership rates remain very low in most malarious areas, including our study areas in rural Orissa (India). Despite the un-subsidized price, 52 percent of sample households purchased at least one ITN, leading to 16 percent of individuals using a treated net the previous night, relative to only 2 percent in control areas where nets were not offered for sale. However, the increase fell significantly short of the 47 percent previous-night usage rate achieved with free distribution. Most strikingly, we find that neither micro-loans nor free distribution led to improvements in malaria and anemia prevalence, measured using blood tests. We examine and rule out several plausible explanations for this latter finding. We conjecture that insufficient ITN coverage is the most likely explanation, and discuss implications for public health policy.

Keywords: Malaria, Bednets, Microfinance, Public Health

JEL Classification: I1, I3

Suggested Citation

Tarozzi, Alessandro and Mahajan, Aprajit and Blackburn, Brian and Kopf, Daniel and Krishnan, Lakshmi and Yoong, Joanne, Micro-Loans, Insecticide-Treated Bednets and Malaria: Evidence from a Randomized Controlled Trial in Orissa (India) (March 9, 2011). Economic Research Initiatives at Duke (ERID) Working Paper No. 104. Available at SSRN: https://ssrn.com/abstract=1881075

Aprajit Mahajan

Stanford University ( email )

Stanford, CA 94305
United States

University of California, Berkeley - Department of Agricultural & Resource Economics ( email )

Berkeley, CA 94720
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Brian Blackburn

affiliation not provided to SSRN ( email )

Daniel Kopf

affiliation not provided to SSRN ( email )

Lakshmi Krishnan

affiliation not provided to SSRN ( email )

Joanne Yoong

RAND Corporation ( email )

1200 South Hayes St
Arlington, VA 22202
United States

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