Community-Level Point Distribution of ITNS (3DE)
Insecticide-treated nets (ITNs) are known to be a cost-effective tool to decrease malaria incidence, which is a leading cause of infant and maternal mortality, low birth-weights, and a high proportion of hospital and out-patient visits in Zambia. However, only 25% of under-five children consistently sleep under a bed net.[i] In 2014, Zambia and its partners were set to distribute 6-7 million ITNs nationwide, but the most efficient distribution and hang-up approach were undetermined.
Volunteers were supposed to distribute ITNs 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 ITN distribution and usage at times. Zambia’s MoH and MoCDMCH commissioned an impact evaluation to compare the cost-effectiveness of alternative distribution approaches to yield high ITN usage.
IDinsight designed and implemented a randomized controlled trial to generate rigorous 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.
[i] Ministry of Health of Zambia. Demographic and Health Survey 2007.