Indoor Residual Spraying

The Proof is in the Planning, Supervision and Monitoring

PMI VectorLink Ensures Efficiency, Quality & Sustainability in Vector Control Operations

Vector Control Operations require rigorous planning, supervision, and monitoring. The PMI VectorLink Project has developed standardized planning tools, job aids, and supervisory checklists to ensure efficiency, quality, and consistency. With standardized tools, the project supports host-country governments at all levels–national, district, and local–to execute and sustain indoor residual spray (IRS) and other vector control activities.

Planning Tools

Determining quantities of resources and where to distribute them requires significant planning efforts.

PMI VectorLink uses a Quantification Tool to calculate the total amounts of the various resources, such as spray equipment, insecticide, and Personal Protective Equipment, required for a successful spray campaign. This tool is used at government and stakeholder meetings to support planning efforts at the national level and contributes to annual work planning efforts for the project.

Once the total amounts are decided, micro-planning meetings are held at the district level with all the relevant stakeholders, including technical officials, political leaders, and other key influencers to where and how resources will be allocated. A Micro-Planning Tool guides the process. This tool is more detailed than the Quantification Tool as it calculates by district the quantities of each resource needed at each spray operation site. The Micro-Planning Tool also determines the number of seasonal workers needed to carry out the campaign, i.e. spray operators, team leaders, supervisors, storekeepers, washers, security guards, pump technicians, etc.

To guide planning activities throughout the year, PMI VectorLink uses a standardized Operational Plan across all country programs. This tool translates the strategies and approaches written in an annual country work plan into the year-round field activities that lead to successful vector control interventions. This standardized tool ensures that activities take place in the same way, at the right time, and in the right order.

As the date for the launch of the spray campaign approaches, logistics preparations intensify. To support in-country teams, PMI VectorLink developed the Electronic Race to the Starting Line (eRSL) Tool, which automates the critical milestones that must be achieved in the final nine weeks before the start of an IRS campaign to ensure it begins on time.

PMI VectorLink developed Spray Calendars to reduce the length of IRS campaigns and promote operational and cost efficiency while maximizing IRS coverage. Spray calendars provide spray teams with daily itineraries throughout the spray period to ensure all households targeted for a vector control intervention are visited comprehensively and efficiently. Spray Calendars enable field teams to develop accurate and efficient transportation plans, which for example, ensure vehicles are rented and fueled only on days when they are absolutely required. 

Community Mobilization

The PMI VectorLink Project balances the need to ensure target communities–most often hundreds of thousands of households–are informed, prepared, and ready to receive IRS with the project’s cross-cutting objectives of cost effectiveness and sustainability. PMI VectorLink employs novel mobilization strategies across countries including radio talk shows, community self-mobilization, and the targeted use of social media. These approaches complement or even replace traditional mobilization strategies such as door-to-door visits and engaging traditional leaders, but consistent across approaches is that the project works with local partners to inform community members about malaria, the benefits of vector control, and how to prepare for and participate in IRS campaigns. This allows PMI VectorLink to achieve high coverage rates.

Scaling-up Capacity and Training

The PMI VectorLink Project has made major strides in capacity building for planning, implementation, and monitoring of IRS to prevent malaria. Leaders and managers at all levels of planning and implementation (central, regional, district and community) have acquired skills and knowledge to effectively and independently conduct high quality IRS campaigns. For example, while PMI VectorLink leads IRS
implementation in Malawi in one district, the project provides routine technical assistance to local health ministries and NGOs in spray planning, supervision, monitoring and evaluation to support government-funded IRS in three districts. In addition to the leaders, tens of thousands of community-level workers have been equipped to deliver IRS at the household level.

Supervision

PMI VectorLink trains and supports district officials, and other relevant stakeholders in the supervision of spray activities in the communities. Supervision Checklists were developed for supervisors of spray campaigns. The supervisors include project staff and Government/District officials. The checklists cover all the key aspects of spray operations, such as compliance to safety procedures, spray personnel conduct in the community, and insecticide application techniques. The checklists, which come in both paper and digital (e-) formats, include:

  1. Spray Operator Morning Mobilization & Transportation Vehicle Inspection
  2. Storekeeper Performance
  3. Homeowner Preparation & Spray Operator Performance; and
  4. End-of-Day Cleanup

Monitoring Performance

IRS requires strict supervision and monitoring to ensure spray activities are carried out safely, efficiently and successfully. PMI VectorLink’s performance culture in IRS implementation among spray personnel helps to guarantee the objectives of spray campaigns are achieved.

PMI VectorLink’s Spray Performance Tracking Sheet enables supervisors and spray teams to measure their performance against set targets on a day-to-day basis. The tool allows all cadres of spray campaign supervisors, including Team Leaders, to have access to performance data in real time. This enables them to promptly address any issues that may arise in the course of a spray day, and to take relevant remedial actions to ensure the success of a spray campaign.

The Spray Performance Tracking Sheet measures performance against the two critical operational indicators:

  1. The number of structures sprayed per spray operator per day, 
  2. The number of structures sprayed per unit (sachet or bottle) of insecticide, and 
  3. Spray progress and coverage rates

PMI VectorLink developed and rolled out a mobile, SMS-based version of the performance tracker. The Performance Monitoring Tool (PMT) enables daily monitoring of spray performance and the insecticide stock by all partners and stakeholders involved in supervision of spray activities, including district and MOH officials. As a mobile summary of the Spray Performance Tracking Sheet across IRS operations sites, the PMT enables prompt decision making during spray campaigns using daily IRS data.

Logistics and Warehouse

The project’s logistics, supply chain, and warehousing procedures conform to the guidelines and requirements of the PMI Best Management Practices. On average, a country will have around 30-50 stores spread across the target spray area, but some countries use hundreds of stores as part of a community-based approach.

PMI VectorLink developed and standardized a digital supply chain for insecticide stock management. All insecticide is serialized upon receipt from the manufacturer, and storekeepers are trained to scan digital barcodes to record the stock movement along the supply chain. Team Leaders also account for insecticide stock movement when issuing and collecting daily insecticide from spray operators using the Team Leader Serialized Insecticide Tracker, a tool that takes stock management practices to the ‘last mile.’

Job Aids

With 400 – 900 spray operators in the field during a campaign, standard procedures are essential to ensuring success. The project uses job aides for the different positions held by temporary employees of spray campaigns to achieve a higher level of standardization in operational performance.

The Spray Operator Pocket Guide, Team Leader Guide, and the IRS Storekeeper Pocket Guide can be referenced quickly in the field should any operational or safety questions and concerns arise, and help personnel perform their jobs successfully.