Evaluation of a continuous community-based ITN distribution pilot in Lainya County, South Sudan 2012–2013

Malaria Journal

Research

Kojo Lokko¹  Hannah Koenker¹  Sean Blaufuss¹  Tafadzwa Matova²  Miatta Zenabu Gbanya²  Matthew Lynch²  Lisa Woods Schnurr²  Ruth Allan²  Richmond Ato Selby³  Albert Kilian⁴  George Greer⁵  Martin Swaka⁶  Lilia Gerberg⁶  Megan Fotheringham⁶ 

[1] Johns Hopkins University Center for Communication Programs, Baltimore, USA;Malaria Consortium, Juba, South Sudan;Malaria Consortium, London, UK;Johns Hopkins University Center for Communication Programs, Baltimore, USA;Malaria Consortium, London, UK;Tropical Health LLP, Montagut, Spain;President’s Malaria Initiative, U.S. Agency for International Development, Dar es Salaam, Tanzania;President’s Malaria Initiative, U.S. Agency for International Development, Washington D.C., USA;

关键词: Insecticide-treated net;    Malaria;    South Sudan;    Community-based;    Insecticide-treated net distribution;   

DOI  :  10.1186/s12936-017-2020-8

 received in 2017-08-01, accepted in 2017-09-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundContinuous distribution of insecticide-treated nets (ITNs) has now been accepted as one way of sustaining ITN universal coverage. Community-based channels offer an interesting means of delivering ITNs to households to sustain universal ITN coverage. The objective of this study was to provide proof of concept for this channel.MethodsA 9-month, community-based, distribution pilot was implemented beginning 1 year after a mass campaign in Lainya County, South Sudan from 2012 to 2013. Following social mobilization, community members could request an ITN from a net coupon holder. Eligibility criteria included having lost an ITN, giving birth outside of the health facility, or not having enough ITNs for all household members. After verification, households could exchange the coupon for an ITN at a distribution point. The evaluation was a pre/post design using representative household surveys with two-stage cluster sampling and a sample size of 600 households per survey.ResultsAt endline, 78% of respondents were aware of the scheme and 89% of those also received an ITN through community-based distribution. Population access to ITNs nearly doubled, from 38% at baseline to 66% after the pilot. Household ownership of any ITN and enough ITNs (1 for 2 people) also increased significantly, from 66 to 82% and 19 to 46%, respectively. Community-based distribution was the only source of ITNs for 53.4% of households. The proportion of the population using an ITN last night increased from 22.7% at baseline to 53.9% at endline. A logistic regression model indicates that although behaviour change communication was positively associated with an increase in ITN use, access to enough nets was the greatest determinant of use.ConclusionsITN access and use improved significantly in the study area during the pilot, coming close to universal coverage targets. This pilot serves as proof of concept for the community-based distribution methodology implemented as a mechanism to sustain ITN universal coverage. Longer periods of implementation should be evaluated to determine whether community-based distribution can successfully maintain ITN coverage beyond the short term, and reach all wealth quintiles equitably.

【 授权许可】

CC BY   
© The Author(s) 2017