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Although our study shows a significant impact of the unsubsidised procurement process on LLIN unit costs, the reduction in unit cost is not large enough to compensate for the price of the LLINs, leading to an overall higher cost. This indicates that the significant amount of LLINs that were not traded in the unsubsidised procurement process is not consumed but are actually discarded due to either defects or during household or community repairs. Households frequently had more than one net and these were often repaired. Although repair is recognized as a healthy practice among community members and is inexpensive, an investment of this kind could possibly amount to a substantial portion of the net’s netting. The comparative costing presented in this paper does not account for the entire amount of LLINs discarded. The overall lower unit cost of LLINs in the study area compared with local retailers suggests that the availability of LLINs at reduced unit costs has a negative impact on local LLIN sales. Although the results presented here cannot be generalised to all LLIN distributors, we believe that the findings are realistic regarding the costs and the returns to LLIN distributors in the studied areas.
We would like to express our deepest thanks to the local authorities and health promoters of San Juan district who supported the research. We are grateful to all community members in the study region for their time and efforts while participating in the study and their confidence in our research. We would also like to thank Jessica Rockwood for assistance on explaining the LLIN tendering process and procurement; and, Jeroen Keijman and Ana Santos of RKS Architects (
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