Across Africa, children in rural areas are just as likely as
children in urban areas to sleep under ITNs, which are
commonly distributed for free in national, communitybased
distribution campaigns. Yet while there is equity in
sub-Saharan Africa as a whole, some countries have glaring
disparities. Recent surveys in Burkina Faso, the Central
African Republic, Niger, Uganda and the United Republic
of Tanzania show that urban children in these countries
are at least twice as likely as rural children to sleep under
ITNs. Throughout the region, rural children with fever are
less likely than urban children to receive antimalarial drugs,
which are mainly provided through clinics.
In all sub-Saharan African countries for which such data are
available, there is a strong relationship between household
wealth and the utilization of ITNs and antimalarials by
children. Children in the richest households are 60 per cent
more likely than children in the poorest households to sleep
under ITNs, and they are 70 per cent more likely to receive
antimalarials when they have a fever.Recent survey data
from Angola, Burkina Faso, Cameroon, Chad, Côte d’Ivoire,
Guinea-Bissau, Nigeria and Somalia indicate that children in
the richest households are at least twice as likely as children
in the poorest households to receive antimalarials when
they have a fever.
While disparities by area of residence and household
wealth exist, boys and girls are equally likely to benefit
from key malaria interventions.
Such disparities point to the importance of considering
how existing financial, geographical and social barriers
affect the most vulnerable populations. These barriers
must be taken into consideration when planning the
delivery of services.