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School-delivery of ITNs -- a good idea?

By Mitsuru Toda Moderator Emeritus | 19 Oct, 2009 Last edited by Robert Szypko on 01 Aug 2011

Currently, various schemes exist to achieve universal access to ITNs. One of them include free distribution of ITNs in antenatal clinics. (Guyatt HL, et al. “Free bednets to pregnant women through antenatal clinics in Kenya: a cheap, simple and equitable approach to delivery.” http://www.ncbi.nlm.nih.gov/pubmed/12000650) The article below suggests school-delivery of ITNs.

What are the pros and cons of school-delivery of ITNs. Would it be a good strategy to achieve universal coverage?


School-Age Children Most Vulnerable To Malaria Infection In Africa, Study Says

Monday, October 19, 2009
Children and adolescents between the ages of 5 and 19 in malaria-endemic African countries are "the most vulnerable group to malaria following the successful distribution of the free bednets to protect children under five and pregnant women against the killer fever," according to a study published in the journal BMC Public Health, the East African reports. The study, which looked at data taken from 18 countries in sub-Saharan Africa countries between 2005 and 2009, found that although people in this age group were exposed to malaria, they were less likely than other groups – including children younger than 5 and pregnant women – to have access to insecticide-treated nets (ITNs). Approximately 80 percent of human-to-mosquito malaria transmission comes from people older than age 5, the East African writes.

The authors conclude that "school-age children are the least protected with ITNs. School-delivery of ITNs, therefore, should be considered as an approach to reach universal coverage and improve the likelihood of impacting upon malaria parasite transmission." In BMC Public Health, they write, "As most sub-Saharan African countries move towards universal coverage of ITNs it becomes important that national survey data can be used to redefine optimal approaches to this new strategy. Therefore data on ITN use must be collected for all household members and not ... for those only under the age of five years and pregnant women" (Noor et al., 10/1).

The Kaiser Daily Global Health Policy Report is published by the Kaiser Family Foundation. © 2009 Henry J. Kaiser Family Foundation. All rights reserved.




BANA FIDELE Replied at 7:46 AM, 30 Oct 2009

Distributing ITNs is the first step.
Making sure it is used is more complicated.
there is need of continuos Monitoring and evaluation to know who is using ITNs in the household and how many night per week it's beeing used.

A population centred approach should allow to know barriers to ITN usage. There exist wrong ideas on ITNs ; they should be known before distributing ITNs.

Such an approach can allow to know to whom ITNs should be distributed.

Bolanle Bukoye Replied at 4:50 PM, 11 Nov 2009

This is a very interesting finding given that most malaria interventions are focused mainly on children below the age of 5 and pregnant women.

We should however learn from the past interventions regarding ITN use. Just as Bana mentioned in the previous post, we must device ways to ensure that people not only have access to ITN's but that ITN's are being used effectively and consistently.

Perhaps it is time to engage the community in ensuring that use of ITN's becomes a reality. In many rural areas, community based approach are already in existent and community health workers may be employed to ensure ITN use and to monitor timely re-treatment of the bed nets.

Simply distributing the nets without making additional efforts to ensure consistent use is simply a waste of limited resources.

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