Volume 71, Issue 2_suppl
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Malaria, more than any other disease of major public health importance in developing countries, disproportionately affects poor people, with 58% of malaria cases occurring in the poorest 20% of the world’s population. If malaria control interventions are to achieve their desired impact, they must reach the poorest segments of the populations of developing countries. Unfortunately, a growing body of evidence from benefit-incidence analyses has demonstrated that many public health interventions that were designed to aid the poor are not reaching their intended target. For example, the poorest 20% of people in selected developing countries were as much as 2.5 times less likely to receive basic public health services as the least-poor 20%. In the field of malaria control, a small number of studies have begun to shed light on differences by wealth status of malaria burden and of access to treatment and prevention services. These early studies found no clear difference in fever incidence based on wealth status, but did show significant disparities in both the consequences of malaria and in the use of malaria prevention and treatment services. Further study is needed to elucidate the underlying factors that contribute to these disparities, and to examine possible inequities related to gender, social class, or other factors. To achieve impact and overcome such inequities, malaria control efforts must begin to incorporate approaches relevant to equity in program design, implementation, and monitoring and evaluation.


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  1. Gwatkin DR, Guillot M, 2000. The Burden of Disease among the Global Poor: Current Situation, Future Trends, and Implications for Strategy. Geneva: Global Forum for Health Research Publications.
  2. Castro-Leal F, Dayton J, Demery L, Mehra K, 1999. Public social spending in Africa: do the poor benefit? World Bank Res Observer 14 : 49–72.
    [Google Scholar]
  3. Whitehead M, 1992. The concepts and principles of equity and health. Int J Health Services 22 : 429–445.
    [Google Scholar]
  4. Sachs J, Malaney P, 2002. The economic and social burden of malaria. Nature 415 : 680–685.
    [Google Scholar]
  5. Filmer D, 2002. Fever and Its Treatment in the More and Less Poor in Sub-Saharan Africa. Washington, DC: World Bank. World Bank Policy Research Working Paper #WPS2789.
  6. Schellenberg JA, Victoria CG, Mushi D, de Savigny D, Schellenberg D, Mshinda H, Bryce J, 2003. Inequities among the very poor: Health care for children in rural southern Tanzania. Lancet 361 : 561–566.
    [Google Scholar]
  7. Abdulla S, Schellenberg JA, Nathan R, Mukasa O, Marchant T, Smith T, Tanner M, Lengeler C, 2001. Impact on malaria morbidity of a programme supplying insecticide treated nets in children aged under 2 years in Tanzania: Community cross sectional study. BMJ 322 : 270–273.
    [Google Scholar]
  8. Ettling M, 1994. Economic impact of malaria in Malawian households. Trop Med Parasitol 45 : 74–79.
    [Google Scholar]
  9. Fawole OI, Oneadeko MO, 2001. Knowledge and home management of malaria fever by mothers and care givers of under five children. West Afr J Med 20 : 152–157.
    [Google Scholar]

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  • Received : 21 Aug 2003
  • Accepted : 06 Jan 2004
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