Integrated ITN catch-up in campa by pengtt


									Integrated ITN catch-up in

 Experience from Lindi and Mtwara
   Alex Mwita – NMCP Tanzania

3rd WIN meeting, Basel 1st - 3rd March
       Background- Chronology
• In January, 2005 at the Davos Economic
  Summit, Sharon Stone initiated a fundraising
  campaign for ITNs for the children of Tanzania
  for and on behalf of retired President Mkapa
• 1million USD pledged
• In April NMCP and GFCCM Tanzania strongly
  urged by RBM Secretariat to use this money for
  free ITNs distribution despite the ongoing
  voucher scheme, already 7 months in operation
      Background- Chronology..2
• A consensus reached to buy LLNs and piggyback onto
  the measles, Vit. A, deworming campaign due in July,
• Lindi and Mtwara regions selected for free distribution
  due to their highest levels of child mortality
• Lindi: IMR 129/1000, <5 Mort. 217/1000
• Mtwara: IMR 126/1000, <5 Mort . 212/1000
• National average: IMR: 99/1000, <5 112/1000
• The two regions informed, upbeat, starts advocacy
• NMCP teams up with EPI programme and other
  partners to work on the logistics
     Background- Chronology..3
• NMCP places an order for LLN with A-Z factory
  promising, money soon coming from Geneva
• By June, promised 1m USD nowhere to be
  seen, UNICEF steps in to rescue the situation
• A-Z cancels LLN orders, says there enough
  bundled nets, if we wish
   Background- Chronology..4
• Decision reached to go for bundled nets
  and to limit distribution to Lindi region
• Mtwara slated for December 2005
• 147K Usd of Sharon’s funds finally arrives
  in September 2005
    Number of nets distributed
• Lindi-165,000 bundled nets
• Mtwara- 215,250 bundled nets
• Red Cross distributed--- nets to some
  wards in Rufiji and Pangani districts
  Evaluation of Lindi campaign
• Results: 574 households with 354
  children less than five years old were
• Of eligible children, 79.6% received a bed
  net, 82.5% received measles vaccine,
  80.6% received mebendazole and 85.0%
  received vitamin A.
   Evaluation-November 2005
• As a consequence of the campaign,
  household ownership of any bed net
  increased from 53.0% to 69.3% with an
  equity ratio of 0.97.
• Household ownership of an insecticide
  treated bed net (ITN) increased from
  13.3% to 24.7%.
   Evaluation-November 2005
• Caretakers reported that 46.3% of all
  children less than 5 years old slept under
  a bed net

• and 21.5% of children less than 5 years
  old slept under an ITN the previous night.
   Evaluation-November 2005
• 35.9% of children less than five years old
  were reported to have slept under a
  campaign net the previous night,

• and 17.7% of children less than five years
  old were reported to have slept under a
  campaign ITN the previous night.
       Bednet and ITN Use
• Use of ITNs was lower than ownership.
• The most common reasons for not using a
  net were lack of mosquitoes 63.1%
• and the net not hanging 31.9%
   Evaluation-November 2005
• Discussion: Integration of malaria
  prevention activities with immunization
  campaigns is an important strategy to
  rapidly increase coverage and use of bed
  nets and merits continued large-scale
  implementation and evaluation.
       Implications of free ITNs
       distribution for Tanzania
• The policy – cost sharing. Waivers for the
  vulnerable, senior poor citizens >60yrs and the
• Free distribution improves net coverage in a
  short period
• Free distribution discourages commercial sector
• The Voucher scheme has shown 85%
  redemption rate
• Working out a mechanism for an equity voucher
I thank you for your attention

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