Design, implementation and evaluation of a national campaign to distribute nine million free LLINs to children under five years of age in Tanzania
Design, implementation and evaluation of a national campaign to distribute nine million free LLINs to children under five years of age in Tanzania
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DOI：
10.1186/1475-2875-10-73
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发表时间：
2011-03-31
期刊：
影响因子：
3
通讯作者：
Brown, Nick
中科院分区：
文献类型：
--
作者：
Bonner, Kimberly;Mwita, Alex;Brown, Nick
背景：继 2004 年国家代金券计划向孕妇和婴儿提供高补贴的驱虫蚊帐 (ITN) 后，坦桑尼亚大陆五岁以下儿童 (U5) 的使用率从 2004 年的 16% 增加到 2007 年的 26.2%。2008 年，卫生和社会福利部计划开展一项追赶运动，以快速、公平地提供免费的长效杀虫蚊帐(LLIN) 到坦桑尼亚每名五岁以下儿童。方法：ITN 小组是国家疟疾控制计划 (NMCP) 的一个单位，代表卫生和社会福利部协调该活动。政府承包商培训并协助当地政府官员监督村级志愿者登记所有 U5 以及分发和发放 LLIN。登记结果构成了 LLIN 订单和交付到村级的基础。护理人员在三天内将登记券带到村里的发放站，在那里他们收到了 U5 的 LLIN。活动结束后，五个地区的家庭调查立即评估了杀虫剂蚊帐 (ITN) 的所有权和使用情况。结果：九位捐助者为全国活动捐款，购买并分发了 900 万个 LLIN，平均每个 LLIN 成本为 7.07 美元，包括所有与活动相关的活动。该运动覆盖了坦桑尼亚大陆的所有八个地区，是 2008 年 8 月麻疹/疟疾综合免疫接种期间单独覆盖的第一个地区，并从 2009 年 3 月至 2010 年 5 月一次在一个地区实施。家庭一级的驱虫蚊帐拥有率从坦桑尼亚 2008 年全国平均水平的 45.7% 增加到 63.4%，但地区差异显着。 U5 人群的 ITN 使用率从 28.8% 增加到 64.1%，增长了 2.2 倍，不同地区的增幅在 22.1-38.3% 之间。结论：地方政府当局充分参与的国家级 LLIN 分配策略有助于避免医疗保健系统的额外负担。每个网络的分配成本与其他公共卫生干预措施相当。特别是在农村居民中，驱虫蚊帐的拥有量和使用量对于预期受益人来说显着增加。即将推出的通用 LLIN 分发和进一步的行为改变沟通将在 2010-2011 年进一步改善 ITN 的所有权和使用。
Background: After a national voucher scheme in 2004 provided pregnant women and infants with highly subsidized insecticide-treated nets (ITNs), use among children under five years (U5s) in mainland Tanzania increased from 16% in 2004 to 26.2% in 2007. In 2008, the Ministry of Health and Social Welfare planned a catch-up campaign to rapidly and equitably deliver a free long-lasting insecticidal net (LLIN) to every child under five years in Tanzania.Methods: The ITN Cell, a unit within the National Malaria Control Programme (NMCP), coordinated the campaign on behalf of the Ministry of Health and Social Welfare. Government contractors trained and facilitated local government officials to supervise village-level volunteers on a registration of all U5s and the distribution and issuing of LLINs. The registration results formed the basis for the LLIN order and delivery to village level. Caregivers brought their registration coupons to village issuing posts during a three-day period where they received LLINs for their U5s. Household surveys in five districts assessed ITN ownership and use immediately after the campaign.Results: Nine donors contributed to the national campaign that purchased and distributed 9.0 million LLINs at an average cost of $7.07 per LLIN, including all campaign-associated activities. The campaign covered all eight zones of mainland Tanzania, the first region being covered separately during an integrated measles immunization/malaria LLIN distribution in August 2008, and was implemented one zone at a time from March 2009 until May 2010. ITN ownership at household level increased from Tanzania's 2008 national average of 45.7% to 63.4%, with significant regional variations. ITN use among U5s increased from 28.8% to 64.1%, a 2.2-fold increase, with increases ranging from 22.1-38.3% percentage points in different regions.Conclusion: A national-level LLIN distribution strategy that fully engaged local government authorities helped avoid additional burden on the healthcare system. Distribution costs per net were comparable to other public health interventions. Particularly among rural residents, ITN ownership and use increased significantly for the intended beneficiaries. The upcoming universal LLIN distribution and further behaviour change communication will further improve ITN ownership and use in 2010-2011.