# **1. Introduction**

The take-up and correct usage of anti-mosquito bed nets to prevent malaria are key development issues in Africa and of substantial concern to donors. In order to address behavioral and economic constraints to take-up and correct usage, donor- and government-sponsored bed net distribution programs rely on both pricing strategies (subsidized or free bed nets) and media campaigns. For example, radio broadcasts of health messages is a prominent part of the international Roll Back Malaria program. These programs raise three central questions that are the focus of the analysis here. First, the literature shows that households with greater media access are more likely to receive cash transfers in more established democracies. Does media access also improve household ability to demand non-cash benefits from government in less established democracies? Second, does radio access increase households‘ adoption of healthy practices? And, third, does it support or undermine the implementation of pricing strategies meant to stimulate the take-up of mosquito bed nets? We examine these questions using original data we collected to exploit a ―natural experiment‖ in radio access in Benin, a country with a large donor-funded government program for the distribution of free bed nets. Analysis of these data demonstrates significant, and surprising, effects of media access.

With regard to the first question, whether radio access affects household ability to demand free bed nets, strong evidence from other parts of the world indicates that governments are more likely to target programs offering private benefits to citizens with better access to mass media, including natural disaster relief in India (Besley and Burgess 2002), and welfare payments during the US Great Depression (Strömberg 2004). The results here, in contrast, show that in an environment with additional barriers to government responsiveness, besides citizens‘ lack of information, greater access to mass media does not enable citizens to extract more benefits from government programs. As a consequence, and in contrast to prior research, households living in villages with greater radio access report no more, and in some specifications significantly fewer, free bed nets.

On the other hand, radio access does influence household demand for public health goods: households living in villages with greater radio access are more likely to report paying for bed nets rather than receiving them for free. Similar to the findings in Keefer and Khemani (2010), that media access increases household investment in their children‘s education, we find here that greater radio access shifts private household spending to finance the adoption of healthier practices.

The evidence also reveals a significant effect of media access on the prices that officials charge for government-provided goods and services.<sup>1</sup> Prior research has examined the effects of small changes in prices on both the take-up and intra-household allocation of bed nets, abstracting from the presence of media campaigns to boost household demand (Cohen and Dupas, 2008; Dupas, 2009). Results from Benin suggest that radio access increases household valuation of bed nets. In response to this increase in demand, the local officials responsible for bed net distribution charge a price for nets that they could have distributed for free.

These officials could, in principle, meet increased household demand by increasing supply. However, in contrast to pricing decisions that are effectively within local discretion, supply decisions are not. To increase supply, local officials must petition for and higher authorities must agree to

> 1 In Benin, the government is the dominant provider of bed nets and donors are the main source of finance for government bed net programs. Bed nets are supplied through the regular channels of government health service delivery—by local health workers. Section 3 below provides further details.

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