Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar
Abstract Background Continuous distribution of insecticide-treated nets (ITNs) is thought to be an effective mechanism to maintain ITN ownership and access between or in the absence of mass campaigns, but evidence is limited. A community-based ITN distribution pilot was implemented and evaluated in...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | Malaria Journal |
| Online Access: | http://link.springer.com/article/10.1186/s12936-017-1985-7 |
| _version_ | 1817996099137306624 |
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| author | Celine Zegers de Beyl Albert Kilian Andrea Brown Mohamad Sy-Ar Richmond Ato Selby Felicien Randriamanantenasoa Jocelyn Ranaivosoa Sixte Zigirumugabe Lilia Gerberg Megan Fotheringham Matthew Lynch Hannah Koenker |
| author_facet | Celine Zegers de Beyl Albert Kilian Andrea Brown Mohamad Sy-Ar Richmond Ato Selby Felicien Randriamanantenasoa Jocelyn Ranaivosoa Sixte Zigirumugabe Lilia Gerberg Megan Fotheringham Matthew Lynch Hannah Koenker |
| author_sort | Celine Zegers de Beyl |
| collection | DOAJ |
| description | Abstract Background Continuous distribution of insecticide-treated nets (ITNs) is thought to be an effective mechanism to maintain ITN ownership and access between or in the absence of mass campaigns, but evidence is limited. A community-based ITN distribution pilot was implemented and evaluated in Toamasina II District, Madagascar, to assess this new channel for continuous ITN distribution. Methods Beginning 9 months after the December 2012 mass campaign, a community-based distribution pilot ran for an additional 9 months, from September 2013 to June 2014. Households requested ITN coupons from community agents in their village. After verification by the agents, households exchanged the coupon for an ITN at a distribution point. The evaluation was a two-stage cluster survey with a sample size of 1125 households. Counterfactual ITN ownership and access were calculated by excluding ITNs received through the community pilot. Results At the end of the pilot, household ownership of any ITN was 96.5%, population access to ITN was 81.5 and 61.5% of households owned at least 1 ITN for every 2 people. Without the ITNs provided through the community channel, household ownership of any ITN was estimated at 74.6%, population access to an ITN at 55.5%, and households that owned at least 1 ITN for 2 people at only 34.7%, 18 months after the 2012 campaign. Ownership of community-distributed ITNs was higher among the poorest wealth quintiles. Over 80% of respondents felt the community scheme was fair and simple to use. Conclusions Household ITN ownership and population ITN access exceeded RBM targets after the 9-month community distribution pilot. The pilot successfully provided coupons and ITNs to households requesting them, particularly for the least poor wealth quintiles, and the scheme was well-perceived by communities. Further research is needed to determine whether community-based distribution can sustain ITN ownership and access over the long term, how continuous availability of ITNs affects household net replacement behaviour, and whether community-based distribution is cost-effective when combined with mass campaigns, or if used with other continuous channels instead of mass campaigns. |
| first_indexed | 2024-04-14T02:17:07Z |
| format | Article |
| id | doaj.art-ee4da3ffec434488bf6476c059e8166e |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-14T02:17:07Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-ee4da3ffec434488bf6476c059e8166e2022-12-22T02:18:11ZengBMCMalaria Journal1475-28752017-08-0116111410.1186/s12936-017-1985-7Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, MadagascarCeline Zegers de Beyl0Albert Kilian1Andrea Brown2Mohamad Sy-Ar3Richmond Ato Selby4Felicien Randriamanantenasoa5Jocelyn Ranaivosoa6Sixte Zigirumugabe7Lilia Gerberg8Megan Fotheringham9Matthew Lynch10Hannah Koenker11Malaria ConsortiumTropical Health, LLPJohns Hopkins Center for Communication ProgramsJohns Hopkins Center for Communication ProgramsJohns Hopkins Center for Communication ProgramsCatholic Relief ServicesCatholic Relief ServicesPresident’s Malaria InitiativePresident’s Malaria Initiative, US Agency for International DevelopmentPresident’s Malaria Initiative, US Agency for International DevelopmentJohns Hopkins Center for Communication ProgramsJohns Hopkins Center for Communication ProgramsAbstract Background Continuous distribution of insecticide-treated nets (ITNs) is thought to be an effective mechanism to maintain ITN ownership and access between or in the absence of mass campaigns, but evidence is limited. A community-based ITN distribution pilot was implemented and evaluated in Toamasina II District, Madagascar, to assess this new channel for continuous ITN distribution. Methods Beginning 9 months after the December 2012 mass campaign, a community-based distribution pilot ran for an additional 9 months, from September 2013 to June 2014. Households requested ITN coupons from community agents in their village. After verification by the agents, households exchanged the coupon for an ITN at a distribution point. The evaluation was a two-stage cluster survey with a sample size of 1125 households. Counterfactual ITN ownership and access were calculated by excluding ITNs received through the community pilot. Results At the end of the pilot, household ownership of any ITN was 96.5%, population access to ITN was 81.5 and 61.5% of households owned at least 1 ITN for every 2 people. Without the ITNs provided through the community channel, household ownership of any ITN was estimated at 74.6%, population access to an ITN at 55.5%, and households that owned at least 1 ITN for 2 people at only 34.7%, 18 months after the 2012 campaign. Ownership of community-distributed ITNs was higher among the poorest wealth quintiles. Over 80% of respondents felt the community scheme was fair and simple to use. Conclusions Household ITN ownership and population ITN access exceeded RBM targets after the 9-month community distribution pilot. The pilot successfully provided coupons and ITNs to households requesting them, particularly for the least poor wealth quintiles, and the scheme was well-perceived by communities. Further research is needed to determine whether community-based distribution can sustain ITN ownership and access over the long term, how continuous availability of ITNs affects household net replacement behaviour, and whether community-based distribution is cost-effective when combined with mass campaigns, or if used with other continuous channels instead of mass campaigns.http://link.springer.com/article/10.1186/s12936-017-1985-7 |
| spellingShingle | Celine Zegers de Beyl Albert Kilian Andrea Brown Mohamad Sy-Ar Richmond Ato Selby Felicien Randriamanantenasoa Jocelyn Ranaivosoa Sixte Zigirumugabe Lilia Gerberg Megan Fotheringham Matthew Lynch Hannah Koenker Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar Malaria Journal |
| title | Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar |
| title_full | Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar |
| title_fullStr | Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar |
| title_full_unstemmed | Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar |
| title_short | Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar |
| title_sort | evaluation of community based continuous distribution of long lasting insecticide treated nets in toamasina ii district madagascar |
| url | http://link.springer.com/article/10.1186/s12936-017-1985-7 |
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