A cost analysis of the employer-based bednet programme in Coastal and Western Kenya

Malaria remains a major health problem in Africa. One preventative strategy currently advocated is the use of bednets, preferably treated with insecticide. Many approaches to bednet delivery have been adopted in Kenya, including an employer-based malaria control strategy (EBMC). The cost and sustainability of this approach have not previously been assessed. This paper presents the financial cost (cash expenditure) of the EBMC programme implemented in the Coastal and Western regions of Kenya by the African Medical and Research Foundation (AMREF) between April 1998 and February 2002. Getting a bednet and insecticide to an employee was estimated to cost the provider US$15.8. This could be reduced by US$0.5 if the remaining stocks were liquidated and by an additional US$1.3 if the salvage of capital items is considered. The venture of distributing bednets to employees through the programme proved lucrative to organized community groups (OCGs), for they made between 24 and 29% gross profit from the nets they sold. Consequently, OCGs in nine of the 13 companies involved had retained enough funds from which they could buy and sell bednets without further donor financial support, and this portrays some elements of a sustainable supply system.