Leveraging the services of lay health volunteers to increase access to insecticide-treated bednets

Context: The Ministry of Health Uganda emphasizes the use of bednets as an effective strategy for malaria prevention. Efforts to provide free nets to the most vulnerable, namely children below five years and pregnant women, have faced the challenge of putting in place a transparent mechanism that ensures that the nets reach targeted beneficiaries.

Description: JSI/UPHOLD Uganda, a USAID-funded program supports 34 districts in Uganda to improve the quality and utilization of health and HIV/AIDS services. To ensure rapid and equitable distribution of the bednets, UPHOLD trained and facilitated lay health volunteers called community medicine distributors (CMDs). Under the supervision of local council officials and district health managers, CMDs identified and delivered nets to households with children below five years and imparted behaviour change messages related to proper utilization.

Results: Over a period of three months, 205,155 of the nets were successfully delivered representing an achievement of 79%. This method of mass net distribution was reported to be transparent, effective, time saving and community-owned, although labour intensive and sometimes constrained by transport logistics. A follow-up evaluation revealed a 95% net retention rate, 87% proper utilization rate. Results on effect on malaria prevalence in distribution areas will be presented at the conference.

Recommendations: Programs involved in ITN distribution should consider working with lay health volunteers as an effective method. To succeed, prior orientation of the volunteers, the local leaders and health managers needs to be done. Proper logistical arrangements should be in place to ensure that the nets reach target households.