Before going further into guidance on this it may be useful to review the pros and cons of working outside the fence on malaria control.



  • Designing and implementing an effective community-wide malaria control strategy requires specialised skills in entomology, malaria vector control, case management, community health promotion and communication.
  • Costs:
    Malaria commodity costs can be considerable (WHO, 2012 and Wafula et al., 2010)
    • LLINs cost around $2.7 - $4 per net if bought in bulk, often more if bought in smaller quantities.
    • ACTs cost around $1.3 - $1.4 for an adult treatment course (for the most commonly procured brand which is an artemether-lumefantrine combination).
    • RDTs cost around $0.7 for a multi-species test.
    • IRS costs vary considerable in relation to economies of scale. Where more than 1 million people are protected, as in large national programmes, costs per person protected will be lower; but in smaller programmes, such as those likely to be supported by private companies, costs can be around $5.5 per person protected.
    Expanding services beyond employees to employees’ families or to whole communities can therefore have important cost implications.

    These issues are reviewed again as you work through the following steps in designing a malaria control programme.