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Estimating population access to insecticide-treated nets from administrative data: correction factor is needed.

Albert Kilian1, Hannah Koenker, Lucy Paintain

  • 1Tropical Health LLP, Montagut, Girona, Spain. albert@trophealth.com

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A factor of 1.6 for insecticide-treated nets (ITN) users per net provides more accurate population access estimates than 2.0 or 1.8. This improved accuracy accounts for varying ITN usage, especially when nets are plentiful.

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Systems Research

Background:

  • Population access to insecticide-treated nets (ITN) is crucial for malaria control.
  • Estimating ITN access between surveys using administrative data is necessary for planning.
  • Current methods using multipliers of 2.0 or 1.8 for ITN users have not been validated.

Purpose of the Study:

  • To evaluate the accuracy of current methods for estimating population access to ITN from administrative data.
  • To determine an optimal multiplier for ITN users per net based on empirical data.

Main Methods:

  • Utilized 35 datasets from household surveys across 10 sub-Saharan African countries.
  • Calculated ITN access estimates using administrative data (ITN delivered) and recommended multipliers (2.0 and 1.8).
  • Compared administrative estimates with survey-derived access indicators and employed regression analysis to refine the multiplier.

Main Results:

  • The assumption of 2.0 users per ITN generally overestimated access, particularly at high coverage levels (up to 30 percentage points).
  • Using a multiplier of 1.8 improved estimates but still resulted in overestimation (up to 19 percentage points).
  • Regression analysis indicated a multiplier of 1.64 provides the best prediction, with good accuracy above 55% access.

Conclusions:

  • A multiplier of 1.6 for users per ITN offers a more accurate estimation of population access compared to 2.0 or 1.8.
  • This refined factor accounts for discordant ITN-person pairs and reduced usage when ITN are sufficient.
  • The findings support using a 1.6 multiplier for improved ITN program planning and monitoring.