Experts broadly agree that mosquito nets are one of the best tools in the fight against malaria, to which the World Health Organization attributes hundreds of millions of illnesses each year and about 429,000 deaths in 2015 – almost all of them in sub-Saharan Africa. According to conventional wisdom, the best way to maximize use of mosquito nets in impoverished, malaria-prone parts of the world is distributing them for free.
At a recent university colloquium, economics professor Chris Gingrich presented research suggesting a different paradigm for net distribution. Gingrich’s study, conducted in Tanzania in 2016 during sabbatical leave, in partnership with the Johns Hopkins Bloomberg School of Public Health, examined consumer demand and willingness to pay for different kinds of mosquito nets.
“The fear is when these nets are given away for free, people aren’t going to use them because they have no emotional or financial investment,” said Gingrich, during his colloquium presentation. In areas where free distribution has occurred, he added, it’s common to find them being used as window screens, fishing nets and in other non-prescribed ways.
Gingrich, who conducted related research in Tanzania during a previous sabbatical leave, designed an experiment in which participants received 10,000 shillings (about $4) and were offered a series of chances to buy different kinds and sizes of nets priced between 2,000 and 8,000 shillings.
After surveying 800 participants over a four-week period in two different regions of the country, Gingrich found they had a “very high propensity to buy” mosquito nets, even though they were also allowed to buy nothing and keep all the money they’d been given. Further analysis of the 5,600 data points generated during the study also shows that participants’ choices aligned with the logical consumer behaviors predicted by Econ 101 demand curves.
“I think this is empowering for the average Tanzanian,” Gingrich said. “We know that they are treating these goods like a rational consumer.”
Free distribution programs, which aren’t generally designed to give recipients choices about the kind of net they receive, can send a message of “Don’t complain, you’re poor. If we have one size net, just take it and use it and be quiet,” Gingrich continued. “And this [research] tells us otherwise about people’s preferences …. They make calculated decisions that suit their own situations day to day, and make a rational decision based on that kind of environment.”
Gingrich noted that the sort of subsidized purchase program supported by his research might complement, rather than replace, free distribution programs aimed at the poorest of the poor.
“I’m convinced there might be an opening here for both a co-payment model – which takes advantage of a person’s incentive to actually use the net – and a giveaway model,” he said.