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)
______________________________________________________________________________
There are no replies made for this post yet.