Micro-loans, insecticide treated bednets and malaria: evidence from a randomized controlled trial in Orissa, India

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.This study was partially funded by the National Institute of Allergy and Infectious Diseases R03AI078119 and by the Marie Curie International Incoming Fellowship FP7-PEOPLE-2011-IXF, Proposal ID 298904. This study received IRB approvals from Duke University (protocol #9447-07), Stanford University (8149), the Indian Council of Medical Research (TDR/507/2008-ECD-II), UPF (2011/4543/I), the Institute for Financial Management and Research (Chennai, India) and the Independent Ethics Committee (Mumbai, India