Can Informal Health Providers Help Reach the Last Mile? Experimental Evidence from Nigeria

Abstract:  We evaluate experimentally the impact of a statewide malaria control program implemented in Anambra, one of the most populous states in Nigeria. The intervention promoted the integration of informal health providers (IP) with the Nigerian public health system through training and improved supplies of drugs and rapid diagnostic tests. The program lead to a 42 percent and 35 percent reduction in malaria incidence among children under-5 and 5 to 11, respectively. These impacts are accompanied (and partly driven) by an improvement in household knowledge about malaria prevention and treatment. Impacts are larger in areas where the quality of public health facilities is higher, which likely occurs because in these areas: 1) there is better availability of drugs and RDT tests to be distributed to IPs in the communities; 2) IPs are able to refer patients to better health facilities.