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
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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.
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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.
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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
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