Insecticide-treated Nets

To date, the U.S. President’s Malaria Initiative (PMI) VectorLink Project has conducted insecticide-treated net (ITN) activities in 17 countries in sub-Saharan Africa, in coordination with National Malaria Control Programs (NMCP). These activities range from ensuring state-of-the-art ITN delivery through continuous distribution (CD) channels and mass campaigns, to implementing essential non-distribution research activities such as the durability monitoring of ITNs. PMI VectorLink also provides technical assistance and capacity building to NMCPs, sometimes through embedded staff members. Examples of activities and tools developed over the last year are shown below.

Photo: Laura McCarty/Abt Associates

ITN Continuous Distribution through Various Channels

School Distribution in Zambia

The VectorLink Zambia team worked with the National Malaria Elimination Program and Ministry of Education, as well as the PMI-funded PAMO+ project (which supported social behavior change activities) and GHSC-PSM project (which worked with third party logistics organizations to transport the nets from the central level to the schools). VectorLink provided support to the NMEP in the planning of the campaign, as well as orientation and cascade training sessions for MOH and MOE staff at provincial, district, zonal and school levels, and supervision during distribution. In the span of the five-day campaign, more than 51,000 ITNs procured by PMI were distributed to pupils in Grades 1 and 4 across 426 schools in Chadiza, Chipangali, Katete, and Petauke districts.

ITN Mass Campaign

ITN Mass Distribution in Cote d’Ivoire

In Cote d’Ivoire, PMI VectorLink provided technical assistance for the distribution of 3,074,527 PBO-ITNs in 11 districts. These PBO-ITNs covered 5,479,980 people and 1,017,457 households, representing respectively 96.31% and 94.81% of the people and households registered. To facilitate ongoing improvements during the campaign–as well as implementation of future ITN mass campaigns–VectorLink, in collaboration with the Regional Technical Group, identified key success, lessons learned and recommendations.

One of the keys to the success in PBO focus districts involved the hiring and training of PMI VectorLink District Focal Points positioned in all 11 districts. These Focal Points supported planning, registration supervision, delivery of ITNs to distribution sites, monitoring of campaign data, and effective distribution. The 11 District Focal Points were also responsible for ensuring individuals respected COVID-19 prevention measures. Close coordination between the NMCP and all implementing partners in the mass campaign is critical, especially on key decisions and timelines; ensuring the quality of the microplanning by using updated demographic data is essential to ensure sufficient ITNs are procured for the current population size; involving local transporters in the preparation of the net pre-positioning plan and other tracking tools is important to avoid distribution delays; ensuring consistent messaging can prevent rumors, especially for multi-product campaigns and finally, if the population data is up to date, then a single registration and distribution phase would be feasible for a mass campaign if that approach is chosen by the NMCP.

ITN Durability Monitoring

Addition of New Types of ITNs to Monitoring Activities

PMI VectorLink supports durability monitoring of ITNs to provide country and global stakeholders with actionable evidence on median ITN life and insecticide effectiveness collected under real-life use conditions. Recently, PMI VectorLink has developed a more streamlined protocol for durability monitoring for countries that have already generated considerable ITN durability data and have more focused questions, particularly around durability of new types of nets.

The project collects data on attrition, physical integrity, bio-efficacy, use, and care and repair behaviors of pyrethroid-only ITNs alongside new piperonyl-butoxide (PBO) and dual-active ingredient (AI) ITNs to inform procurement and programmatic decisions and develop effective, evidence-based integrated vector management strategies. PMI VectorLink uses World Health Organization-endorsed ITN durability monitoring resources, which are available at www.durabilitymonitoring.org

Social and Behavior Change Communication (SBCC)

Where needed, PMI VectorLink partners with in-country stakeholders to support activities to assess the barriers and facilitators of vector control-related behaviors, lead or support the design of interventions to address the identified barriers and facilitators, and drive innovation in vector control-related SBCC activities. The project applies malaria SBCC global best practices and draws from resources developed by the Roll Back Malaria Partnership to End Malaria SBCC working group. Learn more at endmalaria.org.