Tuesday, 10 May 2005
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POST 00788E : MEASLES CAMPAIGN AND ITN DISTRIBUTION Follow-up on Posts 00763E, 00765E, 00767E, 00768E, 00771E, 00774E, 00778E, 00781E and 00784E 10 May 2005 _____________________________________ This posting contains two contributions. The first is from Terkula Ben Alagh (mailto:[email protected]) from UNICEF in Nigeria. The second is from Adam Wolkon (mailto:[email protected]) who didn't tell where he is from. Adam is the co-author of an interesting evaluation report "Multidisciplinary Evaluation of the Impact of the 2004 Togo National Integrated Child Health Campaign" that has been widely circulated. For those who haven't seen it already, you can download it from our site: http://www.technet21.org/PrelimReportEvalIntegratedCampaignTogo.doc _____________________________________ I have followed the discussions on the subject and agree that it provides an opportunity to expand net availability to remote and underserved areas. However, as stated, it needs to be managed properly if it is not to detract from the primary concern of reaching every child, itself a challenge to the programme in Nigeria. Recently, a pilot scheme in Southern Nigeria to encourage positive household practices including immunization by giving a net to every child on completion of the primary vaccination series (as well as mothers on registration for ANC) had an unexpected outcome similar to that recorded in Ghana with the Rotary/ExxonMobil scheme. While the programme was well received in project communities, neighbouring areas as well as community residents who did not benefit demanded nets themselves and when they could not get these, refused to submit their children for immunization during subsequent NIDs. I believe one of the critical factors in such instances is adequate information and a sustainability plan to satisfy the demand that would undoubtedly be created, granting that no such scheme can supply every need, every time for all times. Regards. Ben Terkula Ben Alagh APO EPI UNICEF D Field Office Bauchi, Nigeria ------------------------------- Dear All, The key to reducing childhood morbidity and mortality from malaria is attaining high coverage of preventive strategies quickly including the use of insecticide-treated bednets. The malaria community is indebted to the immunization child advocates who have adopted a vaccine model to achieve high ITN coverage. They clearly recognized ITNs as a public health good. Similar to the arguments tendered on this listserv on the sustainability of measles and polio vaccination campaigns without external support and their effect on routine immunization activities, saving children's lives today from malaria can not wait for assuring the ability to sustainably save lives tomorrow. However, we are fortunate that a number of activities are underway to assure long-term sustainability of malaria prevention efforts and there is increasing availability of funds for malaria from the Global Fund, World bank, and other donors. A comparison of direct long-lasting ITN distribution in 4 rural districts in Zambia to provision of a voucher for a free net in one more urban district showed that one month after the campaign only 85% of individuals who had received a voucher had redeemed their voucher for a free net and kit to treat the net. This 15% loss represented a significant missed opportunity to protect eligible children. Voucher distribution was also a more costly distribution mechanism even before accounting for the fact that direct distribution used the more costly long lasting net. The 97% referred to by Mr. McGuire (Post 00778E) was probably for the percentage of nets distributed during the campaign that were still in the household 6 months post distribution in all 5 districts. Six months after the campaign, only 76% of the eligible children had received a net in the voucher district [Kalalushi]. Another interesting observation was that in Zambia, there was a trend that the wealthier households were more likely to use their ITN. In Togo, the reverse was true. Mr. McGuire's anecdote about a MOH official's concern that limited free bednet distribution could actually harm vaccination campaigns validates the approach by the international donor community to fund national direct ITN distribution. The experience in Togo proves that it is logistically feasible - albeit challenging - and does not lower vaccine coverage. In fact, it may actually help coverage since the 'people love it.' Direct ITN distribution in Togo in conjunction with an immunization campaign raised national bednet ownership among the eligible at-risk chidren from 90% in a week with no discrepancy among wealth quintiles. It also increased national household ownership (with or without an eligible child in the household) to >60% in that same time period. We must continue to support any and all mechanisms that allow us to rapidly meet the Abuja targets and the international goal of halving childhood mortality from malaria by 2010. Adam Wolkon ______________________________________________________________________________ ___________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (http://www.ccisd.org) ______________________________________________________________________________
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