Effectiveness and equity of the Tanzania National Voucher Scheme for mosquito nets over 10 years of implementation

Malaria Journal

Case Study

Nick Brown¹  Rose Nathan²  Matthew Lynch³  Renata Mandike⁴  Ally Mohamed⁴  Ally Mnzava⁵  Wilhelmina Rimisho⁵  Karen Kramer⁶  Christian Lengeler⁶ 

[1]A to Z Textile Mills Ltd, Arusha, Tanzania

[2]Ifakara Health Institute, Dar es Salaam, Tanzania

[3]Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

[4]National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania

[5]Swiss Tropical & Public Health Institute, P.O. Box 4002, Basel, Switzerland

[6]National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania

[7]Swiss Tropical & Public Health Institute, P.O. Box 4002, Basel, Switzerland

[8]University of Basel, Petersplatz 1, 4003, Basel, Switzerland

关键词: Public private partnership;    Malaria;    Vector control;    Insecticide-treated nets;    Long-lasting insecticidal nets;    Keep up strategy;    Continuous distribution;    Tanzania;   

DOI  :  10.1186/s12936-017-1902-0

 received in 2017-01-24, accepted in 2017-06-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe Tanzania National Voucher Scheme (TNVS) was a public private partnership managed by the Ministry of Health that provided pregnant women and infants with highly subsidized (long-lasting) insecticide-treated nets between 2004 and 2014. It was implemented in the context of the National Insecticide Treated Nets (NATNETS) Programme and was the main keep up strategy for vulnerable populations.Case descriptionThe programme design was adjusted considerably over time to incorporate new evidence, shifting public health policies, and changing donor priorities. Three TNVS models can be distinguished: (1) the fixed discount; (2) the fixed top-up; (3) the hybrid voucher model. The changes improved equity and effectiveness, but also had a profound effect on how the programme was managed and implemented.ResultsThe TNVS reached the majority of beneficiaries with vouchers, and significantly increased household ownership and use of LLINs. While two mass distribution campaigns implemented between 2009 and 2011 achieved universal coverage and equity, the TNVS ensured continuous protection of the vulnerable populations before, during and after the campaigns. The TNVS stimulated and maintained a large national retail network which managed the LLIN supply chain.Discussion and lessons learnedThe effectiveness of the TNVS was a function of several interdependent factors, including the supply chain of vouchers through the public health system; the supply chain of nets in the commercial sector; the demand for nets from voucher recipients; management and risk mitigation measures; and the influence of global and donor objectives.ConclusionThe TNVS was a highly innovative and globally influential programme, which stimulated the thinking around effectively and equitably distributing ITNs, and contributed directly to the evolution of global policy. It was a fundamental component of the NATNETS programme which protected a malaria-vulnerable population for over a decade.

【 授权许可】

CC BY   
© The Author(s) 2017