January 2002

Government finance for healthcare in China declined during the 1990s. This coincided with the entry of Henan Province (population 90 million) into the consolidation phase of malaria control (in 1993), after a successful effort over the previous 25 years that reduced transmission by 99%. Government support for insecticide spraying and impregnated bednets stopped, and vivax malaria persisted in the south. Knowledge of the economics of malaria control in Henan was lacking and this hampered strategic planning. Health officials had to make funding decisions without knowing the costs and benefits of expenditure on malaria control. 

Henan's malaria control strategy was analysed using primary cost and performance data obtained prospectively from the government and the community over a 2-year period. Results showed features that related well to the 2000 WHO model for assessing health systems based on health attainment, stewardship, equity and fair financing. All community and government costs for malaria control were measured and the cost-performance of case-management for suspected malaria cases in a southern area with continuing transmission was evaluated.