Cargando…
Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best?
BACKGROUND: The use of insecticide-treated nets (ITNs) is widely recognized as one of the main interventions to prevent malaria. High ITN coverage is needed to reduce transmission. Mass distribution campaigns are the fastest way to rapidly scale up ITN coverage. However, the best strategy to distrib...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740992/ https://www.ncbi.nlm.nih.gov/pubmed/26842732 http://dx.doi.org/10.1186/s12936-016-1108-x |
_version_ | 1782413928658108416 |
---|---|
author | Zegers de Beyl, Celine Koenker, Hannah Acosta, Angela Onyefunafoa, Emmanuel Obi Adegbe, Emmanuel McCartney-Melstad, Anna Selby, Richmond Ato Kilian, Albert |
author_facet | Zegers de Beyl, Celine Koenker, Hannah Acosta, Angela Onyefunafoa, Emmanuel Obi Adegbe, Emmanuel McCartney-Melstad, Anna Selby, Richmond Ato Kilian, Albert |
author_sort | Zegers de Beyl, Celine |
collection | PubMed |
description | BACKGROUND: The use of insecticide-treated nets (ITNs) is widely recognized as one of the main interventions to prevent malaria. High ITN coverage is needed to reduce transmission. Mass distribution campaigns are the fastest way to rapidly scale up ITN coverage. However, the best strategy to distribute ITNs to ensure household coverage targets are met is still under debate. This paper presents results from 14 post-campaign surveys in five African countries to assess whether the campaign strategy used had any effect on distribution outcome. METHODS: Data from 13,901 households and 14 campaigns from Ghana, Nigeria, Senegal, South Sudan and Uganda, were obtained through representative cross-sectional questionnaire surveys, conducted three to 16 months after ITN distribution. All evaluations used a multi-stage sampling approach and similar methods for data collection. Key outcomes examined were the proportion of households having received a net from the campaign and the proportion of households with one net for every two people. RESULTS: Household registration rates proved to be the most important determinant of a household receiving any net from the campaign (adjusted odds ratio [OR] 74.8; 95 % confidence interval [CI]: 55.3–101.1) or had enough ITNs for all household members (adjusted OR 19.1; 95 % CI: 55.34–101.05). Factors that positively influenced registration were larger household size (adjusted OR 1.7; 95 % CI: 1.5–2.1) and families with children under five (adjusted OR 1.4; 95 % CI: 1.2–1.6). Urban residence was negatively associated with receipt of a net from the campaign (adjusted OR 0.73; 95 % CI: 0.58–0.92). Registration was equitable in most campaigns except for Uganda and South Sudan, where the poorest wealth quintiles were less likely to have been reached. After adjusting for other factors, delivery strategy (house-to-house vs. fixed point) and distribution approach (integrated versus stand-alone) did not show a systematic impact on registration or owning any ITN. Campaigns that used a universal coverage allocation strategy were more effective in increasing the proportion of households with enough ITNs than campaigns that used a fixed number of ITNs. Registering based on counting usual sleeping spaces resulted in higher levels of households with one net per two people among those receiving any campaign net (adjusted OR 1.6; 95 % CI: 1.07–2.48) than campaigns that registered based on the number of household members. CONCLUSION: All of the campaigns, irrespective of strategy, successfully increased ownership of at least one ITN. Delivery method and distribution approach were not associated with receipt of at least one ITN from the campaign. Rather, the key determining factor for receipt of at least one ITN from the campaign was a successful registration process, which depends on the ability of community volunteers to reach households during the exercise. Universal coverage campaigns, especially those that used a sleeping space allocation strategy, were more effective in increasing the proportion of households with enough ITNs. Maximizing registration completeness and using a universal coverage allocation strategy are therefore likely to improve campaign outcomes. |
format | Online Article Text |
id | pubmed-4740992 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47409922016-02-05 Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? Zegers de Beyl, Celine Koenker, Hannah Acosta, Angela Onyefunafoa, Emmanuel Obi Adegbe, Emmanuel McCartney-Melstad, Anna Selby, Richmond Ato Kilian, Albert Malar J Research BACKGROUND: The use of insecticide-treated nets (ITNs) is widely recognized as one of the main interventions to prevent malaria. High ITN coverage is needed to reduce transmission. Mass distribution campaigns are the fastest way to rapidly scale up ITN coverage. However, the best strategy to distribute ITNs to ensure household coverage targets are met is still under debate. This paper presents results from 14 post-campaign surveys in five African countries to assess whether the campaign strategy used had any effect on distribution outcome. METHODS: Data from 13,901 households and 14 campaigns from Ghana, Nigeria, Senegal, South Sudan and Uganda, were obtained through representative cross-sectional questionnaire surveys, conducted three to 16 months after ITN distribution. All evaluations used a multi-stage sampling approach and similar methods for data collection. Key outcomes examined were the proportion of households having received a net from the campaign and the proportion of households with one net for every two people. RESULTS: Household registration rates proved to be the most important determinant of a household receiving any net from the campaign (adjusted odds ratio [OR] 74.8; 95 % confidence interval [CI]: 55.3–101.1) or had enough ITNs for all household members (adjusted OR 19.1; 95 % CI: 55.34–101.05). Factors that positively influenced registration were larger household size (adjusted OR 1.7; 95 % CI: 1.5–2.1) and families with children under five (adjusted OR 1.4; 95 % CI: 1.2–1.6). Urban residence was negatively associated with receipt of a net from the campaign (adjusted OR 0.73; 95 % CI: 0.58–0.92). Registration was equitable in most campaigns except for Uganda and South Sudan, where the poorest wealth quintiles were less likely to have been reached. After adjusting for other factors, delivery strategy (house-to-house vs. fixed point) and distribution approach (integrated versus stand-alone) did not show a systematic impact on registration or owning any ITN. Campaigns that used a universal coverage allocation strategy were more effective in increasing the proportion of households with enough ITNs than campaigns that used a fixed number of ITNs. Registering based on counting usual sleeping spaces resulted in higher levels of households with one net per two people among those receiving any campaign net (adjusted OR 1.6; 95 % CI: 1.07–2.48) than campaigns that registered based on the number of household members. CONCLUSION: All of the campaigns, irrespective of strategy, successfully increased ownership of at least one ITN. Delivery method and distribution approach were not associated with receipt of at least one ITN from the campaign. Rather, the key determining factor for receipt of at least one ITN from the campaign was a successful registration process, which depends on the ability of community volunteers to reach households during the exercise. Universal coverage campaigns, especially those that used a sleeping space allocation strategy, were more effective in increasing the proportion of households with enough ITNs. Maximizing registration completeness and using a universal coverage allocation strategy are therefore likely to improve campaign outcomes. BioMed Central 2016-02-03 /pmc/articles/PMC4740992/ /pubmed/26842732 http://dx.doi.org/10.1186/s12936-016-1108-x Text en © Zegers de Beyl et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Zegers de Beyl, Celine Koenker, Hannah Acosta, Angela Onyefunafoa, Emmanuel Obi Adegbe, Emmanuel McCartney-Melstad, Anna Selby, Richmond Ato Kilian, Albert Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? |
title | Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? |
title_full | Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? |
title_fullStr | Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? |
title_full_unstemmed | Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? |
title_short | Multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? |
title_sort | multi-country comparison of delivery strategies for mass campaigns to achieve universal coverage with insecticide-treated nets: what works best? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740992/ https://www.ncbi.nlm.nih.gov/pubmed/26842732 http://dx.doi.org/10.1186/s12936-016-1108-x |
work_keys_str_mv | AT zegersdebeylceline multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest AT koenkerhannah multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest AT acostaangela multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest AT onyefunafoaemmanuelobi multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest AT adegbeemmanuel multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest AT mccartneymelstadanna multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest AT selbyrichmondato multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest AT kilianalbert multicountrycomparisonofdeliverystrategiesformasscampaignstoachieveuniversalcoveragewithinsecticidetreatednetswhatworksbest |