Discussion Paper No. 109 of 2010 on Evaluating the Impact of Microfranchising the Distribution of Anti-Malaria Drugs in Kenya on Mortality and Morbidity

Abstract

In an effort to increase access to effective anti-malaria drugs to the rural poor, the Kenyan government has partnered with a local nongovernmental organization to distribute the drugs free of charge using a micro-franchise system in small privately-owned rural shops. This study uses difference-in-difference to evaluate the effectiveness of the programme in increasing access to the drugs and hence on its impact on malaria morbidity and mortality. If effective, this system can be adopted in the distribution of other essential medicines to help in achieving some of the health-related Millennium Development Goals (MDGs) in Africa and Asia. The results show that the programme had significant positive impacts on malaria morbidity. The impact is, however, less when the patients have to walk longer distances to access the drugs. Further, the findings show that even without the free anti-malaria drugs, the outlets in themselves have had a significant negative impact on malaria morbidity. Programme impact on mortality is generally insignificant. The programme is therefore recommendable for replication.