Objective The aim is to compare the cost-effectiveness of two long-lasting insecticidal nets (LLINs) delivery models (standard vs new) in universal coverage (UC) campaigns in rural Mozambique. Results The total financial cost of delivering LLINs was US$ 231,237.30 and US$ 174,790.14 in the intervention (302,648 LLINs were delivered) and control districts (219,613 LLINs were delivered), respectively. The average cost-effectiveness ratio (ACER) per LLIN delivered and ACER per household (HH) achieving UC was lower in the intervention districts. The incremental cost-effectiveness ratio (ICER) per LLIN and ICER per HH reaching UC were US$ 0.68 and US$ 2.24, respectively. Both incremental net benefit (for delivered LLIN and for HHs reaching UC) were positive (intervention deemed cost-effective). Overall, the newer delivery model was the more cost-effective intervention. However, the long-term sustainability of either delivery models is far from guaranteed in Mozambique’s current economic context.

Objective The aim is to compare the cost-effectiveness of two long-lasting insecticidal nets (LLINs) delivery models (standard vs new) in universal coverage (UC) campaigns in rural Mozambique. ResultsThe total financial cost of delivering LLINs was US$ 231,237.30 and US$ 174,790.14 in the intervention (302,648 LLINs were delivered) and control districts (219,613 LLINs were delivered), respectively. The average cost-effectiveness ratio (ACER) per LLIN delivered and ACER per household (HH) achieving UC was lower in the intervention districts. The incremental cost-effectiveness ratio (ICER) per LLIN and ICER per HH reaching UC were US$ 0.68 and US$ 2.24, respectively. Both incremental net benefit (for delivered LLIN and for HHs reaching UC) were positive (intervention deemed cost-effective). Overall, the newer delivery model was the more cost-effective intervention.However, the long-term sustainability of either delivery models is far from guaranteed in Mozambique's current economic context. Setting and locationThe study was conducted in four rural districts of Mozambique. Two districts served as intervention (with the new delivery model); and two served as control (with standard delivery model). These districts were selected based on pragmatic criteria described elsewhere [7]. All four districts are rural, with limited access to health services, and low health, social and economic indicators [7,8]. Study DesignAn observational and cross-sectional study with cost-effectiveness analysis component was carried out using secondary data from the pilot study conducted between October and December 2015 [7]. Collection of cost dataThe campaign costs were retrospectively collected from the providers' perspective. The costs considered were related to training of personnel, allowances, LLINs warehouse storage, LLIN transportation vehicles rental, and materials production (pamphlets, coupons, stickers, etc).These costs were aggregated into four categories: 1) micro-planning; 2) LLIN storage; 3) LLIN transport; 4) mobilization and training at district level, household registration, and LLIN distribution.Costs were collected in Mozambican Metical (local currency) and United States Dollars (US$). In 2015, the exchange rate was: 1 US$ = 42.00 Meticais. No adjustment for inflation was undertaken since all cost were paid in 2015. No discount rate was applied since the temporal universe of analysis did not exceed one year. Comparators: the two delivery modelsBoth delivery models are community-based. One delivery model allocates LLINs based on the assumption of one LLINs for every two persons in a household (intervention districts), and another the number of LLINs is allocated based on assumptions around households members sleeping patterns (control districts). A comprehensive description of the models is reported elsewhere [7,8]. Measurement of effectivenessTwo endpoints were used to measure the effects of the campaign in the intervention and control districts: i) number of LLINs delivered; ii) households (HHs) achieving universal cov...

Objective The aim is to compare the cost-effectiveness of two long-lasting insecticidal nets (LLINs) delivery models (standard vs new) in universal coverage (UC) campaigns in rural Mozambique. Results The total financial cost of delivering LLINs was US$ 231,237.30 and US$ 174,790.14 in the intervention (302,648 LLINs were delivered) and control districts (219,613 LLINs were delivered), respectively. The average cost-effectiveness ratio (ACER) per LLIN delivered and ACER per household (HH) achieving UC was lower in the intervention districts. The incremental cost-effectiveness ratio (ICER) per LLIN and ICER per HH reaching UC were US$ 0.68 and US$ 2.24, respectively. Both incremental net benefit (for delivered LLIN and for HHs reaching UC) were positive (intervention deemed cost-effective). Overall, the newer delivery model was the more cost-effective intervention. However, the long-term sustainability of either delivery models is far from guaranteed in Mozambique’s current economic context.