The impact of Malaria Control Program on child health in Malawi : using Propensity-Score Matching analysis

Abstract

Malaria is still a major killer in Sub-Saharan Africa, causing about 16 per cent of under-five deaths. In Malawi, a sub Saharan African nation, the disease is the number one cause of hospital admissions and leading cause of death among under-five. Globally, there have been renewed efforts to support public health care services in developing countries to fight malaria, which has resulted in a number of comprehensive integrated malaria control interventions being implemented. The government of Malawi launched a malaria intervention scale up in (2005 to 2010) with an aim of reducing malaria in the country. The interventions among other things have been designed to achieve Millennium Development Goal four of reducing under-five mortality by two thirds as it is a known fact that malaria highly impacts the health of children in this region. A number of evaluations have been carried out to assess the impact of Malaria Programme in Malawi; however most of these studies have been descriptive and or qualitative evaluations of the objectives of the programs. Most of these studies as will be shown in the paper, have not taken into account selections bias that are inevitably found as the nature of intervention does not randomly select beneficiaries or are not nationally representative. In this paper, propensity score method is proposed as an evaluation method to control for selection bias by creating control groups for those that benefit from the malaria program interventions. The study will utilise national representative demographic health survey data that was collected by Malawi National Statistics Offices in 2004 and 2010 to evaluate the Malaria control scale up and use anaemia as outcome indicator.