1 Department of Economics and Business, Universitat Pompeu Fabra and Barcelona GSE, Jaume I Building, Ramon Trias Fargas 25-27, 08005 Barcelona, Spain, and Barcelona GSE (e-mail: ) · 2 Economics Department, UCLA, 8283 Bunche Hall, Los Angeles, CA 90095 (e-mail: ) · 3 Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Lane Building, Room L-136 Stanford, CA 94305 (e-mail: ) · 4 Research Division, Savvy Sherpa, 6200 Shinglecreek Parkway, Minneapolis, MN 55430 (e-mail: ) · 5 Independent Science and Partnership Council Secretariat of CGIAR, C6/35, FAO, Viale delle Terme di Caracalla, Rome 00153 (e-mail: ) · 6 National University of Singapore, Saw Swee Hock School of Public Health, 16 Medical Drive, Block MD3 Singapore 117597, and RAND Corporation (e-mail: )
open access
Abstract
We describe findings from the first large-scale cluster randomized controlled trial in a developing country 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. Despite a relatively high price, 52 percent of sample households purchased ITNs, highlighting the role of liquidity constraints in explaining earlier low adoption rates. We find mixed evidence of improvements in malaria indices. We interpret the results and their implications within the debate about cost sharing, sustainability and liquidity constraints in public health initiatives in developing countries.