Do people value free goods? Evidence from distribution of insecticide treated mosquito nets in Tanzania

The study analyzes the impact of distribution mechanisms (free distribution and own purchased) on household utilization of insecticide treated mosquito nets. Considering its health benefit and the associated positive externality, it is argued that subsidization is a necessary means to achieve universal coverage in the context of credit constraints. However, price regulations can distort perception, value and household behavior towards utilization of health commodities. The study aimed at understanding household adoption of ITN in malaria prevention and later the influence of delivery mechanism on effective usage and impact of ITN on household wealth, malaria prevalence in children and growth of children aged 6 to 59 months using Tanzania demographic and health survey data. The hypothesis was that free distribution crowd out effective usage of ITNs compared to own purchased and there is difference in impact of ITNs among different delivery mechanisms. The study shows that liquidity constraint hinders household adoption of ITNs hence free ITNs distribution programs should continue to ease the financial barrier. However, the study found freely obtained nets are less likely to be used compared to own purchased nets and more protective of malaria in children. The study proposes that the use of behavior change and education campaigns to promote usage as it is indicative that though usage is lower, ownership of ITN increases with subsidized ITNs distribution programs. Keywords: Insecticide Treated Mosquito nets, free distribution, owned purchased nets, usage, Tanzania