Cecilia Katebe, Zambia National Malaria Control Centre Zambia uses community volunteers to help hang millions of bednets in homes to improve utilization rates.
Zambia’s National Malaria Control Programme (NMCP) is expected to distribute over 5 million nets in 2011, of which approximately three-quarters shall be distributed using the door-to-door distribution strategy in an effort to increase the usage of the nets being distributed. The remaining quarter will be distributed to pregnant women and children under five years of age through antenatal clinics. A high percentage of people in Zambia own bednets because of the government’s ongoing efforts to scale up the distribution of malaria control interventions, which, in addition to bednets, include indoor residual spraying and effective medicines. Though 64.3 percent of households own at least one bednet, the 2010 Malaria Indicator Survey (MIS) determined that only 42 percent of people were actually using the nets. The NMCC conducted a survey and found that there were a number of reasons for the low utilization rates. Many people said that they weren’t using the nets because they didn’t know how to hang them or they didn’t have the accessories to hang them; others said that they only use the bednets in the rainy season when mosquitoes are very visible.
The door-to-door campaign was launched in 2009 as a means of increasing utilization rates. During the campaign, Community Health Workers, Neighborhood Health Committee members, and other trained volunteers take the nets right up to individual houses and ensure the nets are hung properly before leaving the household. This also provides an opportunity to share important messages on malaria prevention and control.
In November 2009, a door-to-door distribution pilot was conducted in Chongwe District of Lusaka Province and a follow-up survey found that about 93 percent of households that had received nets during the pilot were using those nets. Based on these excellent results, it was decided that the door-to-door distribution strategy would be used to distribute the all the nets received in 2011.
During this year’s mass distribution, one volunteer will be responsible for 20 households in a village and, whenever possible, a volunteer will be chosen that also lives in the village and is a member of the community. This is really useful for several different reasons: the family will already know and trust the volunteer, they will be more likely to be honest about how many nets they need, and they will be more likely to allow them into their bedroom to help hang their nets. There is a high demand for bednets, but the challenge is being allowed into a bedroom to help hang a net. To address this issue, we’ve engaged traditional leaders to help people understand why this is important. The volunteers will then collect the data and bring it to the health center, where it is consolidated and used to determine how many nets a district needs. When the nets arrive, the volunteers will go back to the houses and distribute the nets, helping to hang them in each sleeping space in a household. To do this sort of distribution requires a massive effort with many people participating, so training is key.
Each volunteer visits the same house several times throughout the year. During their first visit, they note the number of sleeping spaces, how many people live in each house, and how many existing nets they have. An ITN database at the central level details all the nets that have been delivered to every district, the type of nets, the program under which the nets were distributed, and the month when the nets were received. This information is used for planning purposes and can produce a forecast that reveals areas of critical need.
Trainings for the upcoming distribution are started when it’s known that a shipment of nets is coming. Districts in need are then identified and a meeting with local stakeholders—including malaria task force committees, ministries, nongovernmental organizations, churches, and local leaders—is arranged. It is important to make sure the district office, with the support of the local partners, is able to handle the storage, distribution, and information-sharing once the nets are received. Health center staff, neighborhood health committees, relevant trainers, and door-to-door distribution volunteers are then trained. Through a strong partnership, coordinating body, and dedicated volunteers, millions of nets will be distributed this year and the work to protect Zambians from malaria will continue.
Door-to-door mass distribution is just one of the ways nets are distributed in Zambia. They are also distributed under the Malaria in Pregnancy Programme through antenatal clinics to pregnant women and children under age five, the Equity Programme to vulnerable populations like the elderly and the chronically ill by NGOs through the MOH, and through the World Bank-supported Community Malaria Booster Response programme.
http://www.macepalearningcommunity.org/newsletter_bednets.htm
Zambia’s National Malaria Control Programme (NMCP) is expected to distribute over 5 million nets in 2011, of which approximately three-quarters shall be distributed using the door-to-door distribution strategy in an effort to increase the usage of the nets being distributed. The remaining quarter will be distributed to pregnant women and children under five years of age through antenatal clinics. A high percentage of people in Zambia own bednets because of the government’s ongoing efforts to scale up the distribution of malaria control interventions, which, in addition to bednets, include indoor residual spraying and effective medicines. Though 64.3 percent of households own at least one bednet, the 2010 Malaria Indicator Survey (MIS) determined that only 42 percent of people were actually using the nets. The NMCC conducted a survey and found that there were a number of reasons for the low utilization rates. Many people said that they weren’t using the nets because they didn’t know how to hang them or they didn’t have the accessories to hang them; others said that they only use the bednets in the rainy season when mosquitoes are very visible.
The door-to-door campaign was launched in 2009 as a means of increasing utilization rates. During the campaign, Community Health Workers, Neighborhood Health Committee members, and other trained volunteers take the nets right up to individual houses and ensure the nets are hung properly before leaving the household. This also provides an opportunity to share important messages on malaria prevention and control.
In November 2009, a door-to-door distribution pilot was conducted in Chongwe District of Lusaka Province and a follow-up survey found that about 93 percent of households that had received nets during the pilot were using those nets. Based on these excellent results, it was decided that the door-to-door distribution strategy would be used to distribute the all the nets received in 2011.
During this year’s mass distribution, one volunteer will be responsible for 20 households in a village and, whenever possible, a volunteer will be chosen that also lives in the village and is a member of the community. This is really useful for several different reasons: the family will already know and trust the volunteer, they will be more likely to be honest about how many nets they need, and they will be more likely to allow them into their bedroom to help hang their nets. There is a high demand for bednets, but the challenge is being allowed into a bedroom to help hang a net. To address this issue, we’ve engaged traditional leaders to help people understand why this is important. The volunteers will then collect the data and bring it to the health center, where it is consolidated and used to determine how many nets a district needs. When the nets arrive, the volunteers will go back to the houses and distribute the nets, helping to hang them in each sleeping space in a household. To do this sort of distribution requires a massive effort with many people participating, so training is key.
Each volunteer visits the same house several times throughout the year. During their first visit, they note the number of sleeping spaces, how many people live in each house, and how many existing nets they have. An ITN database at the central level details all the nets that have been delivered to every district, the type of nets, the program under which the nets were distributed, and the month when the nets were received. This information is used for planning purposes and can produce a forecast that reveals areas of critical need.
Trainings for the upcoming distribution are started when it’s known that a shipment of nets is coming. Districts in need are then identified and a meeting with local stakeholders—including malaria task force committees, ministries, nongovernmental organizations, churches, and local leaders—is arranged. It is important to make sure the district office, with the support of the local partners, is able to handle the storage, distribution, and information-sharing once the nets are received. Health center staff, neighborhood health committees, relevant trainers, and door-to-door distribution volunteers are then trained. Through a strong partnership, coordinating body, and dedicated volunteers, millions of nets will be distributed this year and the work to protect Zambians from malaria will continue.
Door-to-door mass distribution is just one of the ways nets are distributed in Zambia. They are also distributed under the Malaria in Pregnancy Programme through antenatal clinics to pregnant women and children under age five, the Equity Programme to vulnerable populations like the elderly and the chronically ill by NGOs through the MOH, and through the World Bank-supported Community Malaria Booster Response programme.
http://www.macepalearningcommunity.org/newsletter_bednets.htm
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