224992 Impact of a malaria bed-net distribution campaign in Togo: Lessons learned regarding distribution criteria

Wednesday, November 10, 2010 : 9:06 AM - 9:24 AM

Howard Goldberg, PhD , Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
Paul Stupp, PhD , Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
Kanako Ishida , Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
Marcy Erskine, PhD , Canadian Red Cross, Ottawa, ON, Canada
Kodjo Morgah, Dr , Ministry of Health, Lome, Togo
Mark Lapointe, MPH , CDC Foundation, Portland, ME
In December 2004, Togo carried out a National Integrated Health Campaign, in which all households were eligible to receive free insecticide treated bednets (ITN) for every child between the ages of 9 and 59 months throughout the country. In 2008, the Centers for Disease Control and Prevention conducted a nationwide survey designed to measure, among other things, the impact of the ITN campaign on mortality levels among young children. An analysis was carried out to compare mortality changes according to whether or not households received ITNs for their young children and according to whether or not households were eligible to receive ITNs (i.e., whether there were 9-59 month-old children in the household at the time of the distribution). Surprisingly, it was found that, since the campaign, early mortality decreased sharply in households that were not eligible to receive ITNs and increased in households that were eligible, giving the appearance that ITN use was counterproductive. Further analysis, however, revealed that this occurred because the distribution criteria excluded many of the highest risk households from net distribution, since the absence of children in those households was often a result of mortality among young children before the distribution occurred. Meanwhile, the lower risk households received nets because they all contained children who had survived. An important lesson to be learned from this analysis is that campaigns to distribute ITNs (and other potentially life-saving interventions) should take into account factors such as previous mortality in order to improve their impact.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Demonstrate how distribution criteria for bed net distrbution in particular and public health interventions in general can affect the success of the intervention as well as the measurement of the intervention's impact.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I design, implement, and analyze data from projects designed to evaluate the coverage and effectiveness of public health interventions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.