Tuesday, 24 May 2005
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POST 00792E : MEASLES CAMPAIGN AND ITN DISTRIBUTION Follow-up on Posts 00763E, 00765E, 00767E, 00768E, 00771E, 00774E, 00778E, 00781E, 00784E, 00789E and 00789E 24 May 2005 _____________________________________ The first contribution in this posting is from both Karen Kramer (mailto:[email protected]) and Christian Lengeler (mailto:[email protected]). The second is from Rosemary Wellington (mailto:[email protected]) from UNICEF. _____________________________________ One can not stress enough the importance of using the opportunity of the free ITN distribution linked to vaccination to (1) strengthen the existing health system, and (2) avoid detrimental long-term effects. The experience with vouchers in Zambia should certainly be more widely known because it allows in many ways to get the best of two worlds! Tanzania started implementing a voucher scheme for ITNs aimed at pregnant women in October 2004. Currently upscaling is proceeding with the aim to cover the whole country by the end of 2005. In brief, every pregnant woman attending antenatal clinics (in this country attendance rate is well over 80%) receives a counterfeit-proof voucher worth USD 2.7 dollars. With this she can go to any participating retailer and get an ITN at the retail price less the value of the voucher. According to size and shape the top-up by the woman ranges from USD 0.25 to 1. The vouchers are then redeemed by the retailers who receive new nets for wholesalers in exchange, and the wholesalers redeem their vouchers either from the logistics organisation employed by the programme (for cash), or from the net manufacturers (for new nets). So far this seems to be working well, with a high redemption rate of vouchers by women, a functioning redemption mechanism for retailers and wholesalers, earlier and increased attendance at ANC clinics and a substantial boost to the development of the retail sector (+80% retailers in rural areas). So women get protected and the commercial availability for all is improved sustainably. In many ways, giving out vouchers rather than nets makes also the logistics of distribution much easier - for a campaign approach as well as for routine distribution! The incentive for the commercial sector is a subtantial boost in sales with a fast-moving item and a "captive" market. Since there is no additional financial incentive the total transaction cost is actually low. The limitation of the voucher system is that it requires a functioning retailing structure, which is not yet in place in many countries. It is therefore best implemented by linking campaigns with a routine system, which will be able to put the required infrastructure in place before the campaign. --------------------------- If I may add my two-penny worth to on-going discussions on private/public sector "marketing" versus "distribution" of ITNs, we should add the small stuff that makes good sense. For any commodity to enter the market and retain customership, simple things like ensuring the supply-end and securing the demand-end are done consistently. For the latter, it is achieved primarily through advertisements. The example of Coca-cola speaks to us all: why does Coke, for example, keep advertising, in spite of the fact that just about everyone on earth has had a bottle or heard of it - to remind customers that they are still selling! I've heard of an advert from Coke that beats all others - "If you've never heard of Coke, welcome to planet earth!" surrounded by powerful visuals of a tantalizing drink! This is plain common sense and we should consider taking that route. No matter the debate (and they are good and I respect the diversity of views and experiences that go into all), may I ask the question if any country has consistently used the "adverts medium" to inform the public that ITNs exist and that they should continue to buy. This should give us food for thought. While communication campaigns makes large scale "noise" to break into communities and social change communication may over time create ownership and thereby sustainability, there is more to it than both these strategies. So, who bails the cat - the private or public sector in doing common-sense work through consistent advertising on radio, tv, billboards, (and mandatorily work through the Ministries of Education to insist that only ITN varieties should be used in schools) etc. Mosquito nets are not uncommon in Africa, especially in West and Central Africa. Parents or adolescents who have been to boarding schools, for example, already know the importance of the mosquito net so there is a significant mass with such knowledge; even the poor in such communities know and wish they could afford one! So, the challenge then is, following campaigns, there is a need to do the social-marketing-type adverts that introduces the ITN variety and that continuously reminds populations that they are available and worth buying. Surely, we have a thing or two to learn from the likes of Coca-cola! Rosemary Wellington Programme Communication Officer, Immunization ______________________________________________________________________________ ___________________________ 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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