Insecticide-treated nets (ITN) have largely been distributed via mass distribution campaigns. Since 2011, however, the World Health Organization (WHO) has recommended additional ITN distribution via routine antenatal care (ANC) and expanded programme on immunization (EPI) services. Countries have begun to implement these routine facility-based distribution strategies, but inconsistently, and there is little research on outcomes of these new programmes. This paper investigates the impact of ITN distribution policies on children’s net use, comparing countries with different policies in place.
insecticide-treated nets (ITN)
A large proportion of pregnant women in this study were not sleeping under ITNs.
Intensified focus on the poorest, least educated, and most distant from health services is needed to improve equity of ITN availability and usage.
Efforts should focus on correcting misconceptions about malaria transmission, prevention and universal use of ITN/LLINs.
The expanded ITN indicators to assess universal coverage provide strong tools for a comprehensive system effectiveness analysis that produces clear, actionable evidence of progress as well as the need for specific additional interventions clearly differentiating between gaps in ownership and use.
A greater than 50% decline in confirmed malaria cases, admissions and deaths at district hospitals in Rwanda since 2005 followed a marked increase in ITN coverage and use of ACT.
Scaling-up effective malaria interventions reduced malaria-related burden at health facilities by over 75% within 5 years.