Evaluating Community-Level Point Distribution of Insecticide-treated Nets


ClientZambia Ministry of HealthZambia National Malaria Control Centre
Partners: DFIDClinton Health Access Initiative
Location: Zambia
Sector: Health
IDinsight contacts: Paul Wang, Alison Connor
Additional Resources: Policy brief , Journal article

The Problem

In Zambia, malaria is a leading cause of infant and maternal mortality, low birth-weights, and a high proportion of hospital and out-patient visits. Long-lasting insecticide-treated nets (LLINs) are known to be a cost-effective tool to decrease malaria incidence. However, a large share of children in Zambia do not sleep consistently under a bed net.

Evidence Needs

In 2014, the government of Zambia and its partners were set to distribute 6-7 million LLINs. Volunteers were supposed to distribute LLINs door-to-door and hang up each ITN over a sleeping space upon delivery. However, this intensive approach had proved highly challenging in terms of time, cost, and volunteer work burden leading to poor LLIN distribution and usage at times. Zambia’s Ministry of Health commissioned an impact evaluation to compare the cost-effectiveness of alternative distribution approaches to yield high LLIN usage.

IDinsight Service

IDinsight designed and implemented an evaluation with randomized design elements to generate evidence on the impact and cost-effectiveness of switching from a door-to-door distribution model to a point-distribution system with household follow-up.


The evaluation found 96% attendance at distribution by pre-registered households and high LLIN ownership and usage across all study arms.


The Zambian government adopted the community distribution points system for insecticide treated nets, a policy decision estimated to create up to 2 million USD in savings.