Malaria Control and Infant Mortality in Africa

Has massive distribution of insecticide-treated-nets contributed to the reduction in infant mortality in Sub-Saharan Africa over the past 15 years? Using large household surveys collected in 16 countries and exploiting the spatial correlation in distribution campaigns, we estimate the relationship between the diffusion of bednets and the progress in child survival. We find no evidence of a causal link in cities, and no impact either in rural areas with low malaria prevalence. By contrast, in highly malarious rural areas where bednet coverage reached high levels, above 75% of households, infant mortality has been reduced by at least 3 percentage points, which amounts to 25% of the initial mortality. The identified impact is even higher for the children of mothers with no education. It lies at the upper bound found with RCTs, most likely because those were implemented in contexts with lower mortality and/or malaria prevalence.