11.5.1 Mass distribution (catch-up) of nets
A variety of methods are available to distribute ITNs to a whole community, as described below.
ITN distribution via house-to-house visits
The best way to distribute ITNs in the community is to visit every house to distribute them. In this way you can ensure that:
- The nets are given to the right people.
- The nets are hung up and not left in their packages.
- The nets are hung properly.
- People get information about how to hang and use the nets outdoors, if outdoor sleeping is common in the village.
- Non-functional old nets are removed and used for other purposes.
- People receive face-to-face education on the benefits of proper and consistent use of ITNs, including the benefits of putting children under nets as early as possible at night.
However, the problem with house-to-house distribution is that it is time-consuming, so it might take you and your colleagues a lot of time to visit 1,000 or so households. To overcome this problem, you should train volunteer community health workers and village leaders to help with the mass distribution of the nets via house-to-house visits.
Stand-alone ITN distribution campaigns
ITNs can also be distributed to all households in the village that need them by inviting people to come to central distribution points, where households are given ITNs based on the village register. At the same time, education and demonstrations can be given collectively to a large number of people. The advantage of this kind of distribution is that a large number of nets can be distributed quickly. However, the health education messages and practical demonstrations may not be adequately communicated to individuals (Figure 11.4).
Distribution integrated with immunization or outreach campaigns
ITNs can also be delivered through the systems and organisations used to deliver immunization, so immunization and ITNs can be delivered at the same time. ITN distribution can also be linked to the other outreach services such as the structure used to deliver bi-annual vitamin A supplements, de-worming, and nutrition screening campaigns.
The disadvantage of linking ITN distribution to immunization and other outreach programmes is that only households with young children (one to five years old) are targeted by these programmes, so other households will not be covered. In fact, such distribution methods are not generally recommended in Ethiopia, as the country has strong community-based health delivery systems, such as the Health Extension Programme, of which you are a part.
11.5 Methods of ITN distribution
11.5.2 Replacement or ‘keep-up’ distribution