Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008 英文参考文献.docVIP

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Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008 英文参考文献.doc

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Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008 英文参考文献

EffectofInvestmentinMalariaControlonChildMortality inSub-SaharanAfricain2002–2008 YokoAkachi1,RifatAtun1,2* 1Strategy, Performance and Evaluation Cluster, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland, 2Imperial College Business School, ImperialCollege,London,UnitedKingdom Abstract Background:Around8.8millionchildrenunder-fivedieeachyear,mostlyduetoinfectiousdiseases,includingmalariathat accountsfor16%ofdeathsinAfrica,buttheimpactofinternationalfinancingofmalariacontrolonunder-fivemortalityin sub-SaharanAfricahasnotbeenexamined. Methods and Findings: We combined multiple data sources and used panel data regression analysis to study the relationshipamonginvestment,servicedelivery/interventioncoverage,andimpactonchildhealthbyobservingchangesin 34sub-SaharanAfricancountriesover2002–2008.WeusedLivesSavedTooltoestimatethenumberoflivessavedfrom coverageincreaseofinsecticide-treatednets(ITNs)/indoorresidualspraying(IRS).Asanindicatorofoutcome,wealsoused under-fivemortalityrate.GlobalFundinvestmentscomprisedmorethan70%oftheOfficialDevelopmentAssistance(ODA) for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774– 63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369–0.881]. Cumulatively GlobalFundinvestmentsthatincreasedITN/IRScoveragein2002–2008preventedanestimated240,000deaths.Countries withhighermalariaburdenreceivedlessODAdisbursementperperson-at-riskcomparedtolower-burdencountries($3.90 vs.$7.05).IncreasedITN/IRScoverageinhigh-burdencountriesledto3,575livessavedper1millionchildren,ascompared with914livesinlower-burdencountries.ImpactofITN/IRScoverageonunder-fivemortalitywassignificantamongmajor childhealthinterventionssuchasimmunisationshowingthat10%increaseinhouseholdswithITN/IRSwouldreduce1.5 [95%CI:0.3–2.8]childdeathsper1000livebirths. Conclusions:Alongwithotherkeychildsurvivalinterventions,increasedITNs/IRScoveragehassignifi