Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-12

AUTHORS

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

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. More... »

PAGES

327

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12936-017-1985-7

    DOI

    http://dx.doi.org/10.1186/s12936-017-1985-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1091144311

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28797252


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