Vouchers for scaling up insecticide-treated nets in Tanzania: Methods for monitoring and evaluation of a national health system intervention

Hanson, Kara; Rose, Nicolas; Marchant, Tanya; Mponda, Hadji; Jones, Caroline; Bruce, Jane; Stephen, Godlove; Mulligan, Jo-Ann; Mshinda, Hassan; Schellenberg, Joanna

doi:10.1186/1471-2458-8-205

Cited by 51 publications

(49 citation statements)

References 24 publications

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“…The observed difference might be due to the fact that in Tanzania there is a strong national commitment on distribution of ITN among pregnant women. The reasons given for those who did not receive discount voucher is the same as that observed from previous study [11]. Timely uptake of discount voucher was low, possibly due to the fact that majority of the study population made their first ANC visit late.…”

Section: Discussionsupporting

confidence: 55%

“…Although relatively simple, this process involve a sequence of steps that a woman has to attend to ANC, receive the discount voucher and also redeem it for an ITN [10–14]. Findings from this study shows that a higher proportion of pregnant women received discount voucher, this is higher than that observed in Ghana [11] where only 50.7 % of pregnant women received discount voucher. The observed difference might be due to the fact that in Tanzania there is a strong national commitment on distribution of ITN among pregnant women.…”

Section: Discussionmentioning

confidence: 75%

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Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania

2016

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ObjectiveInsecticides treated nets (ITNs) and intermittent preventive therapy with two doses of sulfadoxine-pyrimethamine (SP IPTp) are the cornerstone for malaria control in pregnancy. Despite the coverage of these interventions being high, it is not known whether they confer optimal protection time against malaria in pregnancy. This study investigated the timing and determinants of timely uptake of SP(IPTp) and ITNs and the pregnancy time protected.MethodsA health facility based cross-sectional study was carried out in Bukoba urban district from 16th April to 29 May 2013. Involving pregnant women and post natal mothers attending Reproductive and Child Health (RCH) clinics. Data on their socio-economic background, pregnancy history and attendance to RCH, receipt of a voucher and acquisition of an ITN as well as SP for IPTp were collected. Their responses were validated from the records of antenatal cards. Data was analysed using SPSS computer program version 20.ResultsA total of 530 mothers were recruited. The overall uptake of SP IPTp was 96 % and the uptake of two SP (IPTp) doses was 86 %. Timely uptake of 1st dose was predicted by early antenatal booking, [AOR 2.59; 95 % CI 1.51–4.46; P = 0.001], and the availability of SP at the facility [AOR 4.63; 95 % CI 2.51–8.54; P < 0.0001]. Uptake of 2nd dose was independent of any predictor factors. A total of 486 (91.6 %) women received ITNs discount vouchers at different gestational age and of these, less than a quarter (21.4 %) received timely. Timely receipt of discount voucher was highly predicted by early antenatal booking [AOR 200; 95 % CI 80.38–498; P < 0.0001].ConclusionAlthough there is a high coverage of SP IPTp and discount vouchers for ITNs, timely uptake and therefore optimal protection time depended on early antenatal booking, the availability of (SP IPTp) and discount voucher at the health facility.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 75%

Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania

2016

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“…Timely reporting of information has been found in neighbouring Tanzania as aiding malaria control programme managers in the prompt identification of problems that arise during implementation of interventions [53]. Such village-level feedback could be crucial in helping programme managers in Uganda to assess whether or not particular IVM initiatives are successful.…”

Section: Discussionmentioning

confidence: 99%

Integrated vector management for malaria control in Uganda: knowledge, perceptions and policy development

Mutero

Schlodder

Kabatereine

et al. 2012

Malar J

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BackgroundIntegrated vector management (IVM) is increasingly being recommended as an option for sustainable malaria control. However, many malaria-endemic countries lack a policy framework to guide and promote the approach. The objective of the study was to assess knowledge and perceptions in relation to current malaria vector control policy and IVM in Uganda, and to make recommendations for consideration during future development of a specific IVM policy.MethodsThe study used a structured questionnaire to interview 34 individuals working at technical or policy-making levels in health, environment, agriculture and fisheries sectors. Specific questions on IVM focused on the following key elements of the approach: integration of chemical and non-chemical interventions of vector control; evidence-based decision making; inter-sectoral collaboration; capacity building; legislation; advocacy and community mobilization.ResultsAll participants were familiar with the term IVM and knew various conventional malaria vector control (MVC) methods. Only 75% thought that Uganda had a MVC policy. Eighty percent (80%) felt there was inter-sectoral collaboration towards IVM, but that it was poor due to financial constraints, difficulties in involving all possible sectors and political differences. The health, environment and agricultural sectors were cited as key areas requiring cooperation in order for IVM to succeed. Sixty-seven percent (67%) of participants responded that communities were actively being involved in MVC, while 48% felt that the use of research results for evidence-based decision making was inadequate or poor. A majority of the participants felt that malaria research in Uganda was rarely used to facilitate policy changes. Suggestions by participants for formulation of specific and effective IVM policy included: revising the MVC policy and IVM-related policies in other sectors into a single, unified IVM policy and, using legislation to enforce IVM in development projects.ConclusionIntegrated management of malaria vectors in Uganda remains an underdeveloped component of malaria control policy. Cooperation between the health and other sectors needs strengthening and funding for MVC increased in order to develop and effectively implement an appropriate IVM policy. Continuous engagement of communities by government as well as monitoring and evaluation of vector control programmes will be crucial for sustaining IVM in the country.

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“…Surveys enumerated which household members slept under each net the previous night and which slept without a net [16,19]. Researchers studied intra-household “net equity” by determining who slept under treated versus untreated nets and who slept under nets with fewer holes [16].…”

Section: Introductionmentioning

confidence: 99%

Decision-making on intra-household allocation of bed nets in Uganda: do households prioritize the most vulnerable members?

Lam

Harvey

Monroe

et al. 2014

Malar J

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BackgroundAccess to insecticide-treated bed nets has increased substantially in recent years, but ownership and use remain well below 100% in many malaria endemic areas. Understanding decision-making around net allocation in households with too few nets is essential to ensuring protection of the most vulnerable. This study explores household net allocation preferences and practices across four districts in Uganda.MethodsData collection consisted of eight focus group discussions, twelve in-depth interviews, and a structured questionnaire to inventory 107 sleeping spaces in 28 households.ResultsIn focus group discussions and in-depth interviews, participants almost unanimously stated that pregnant women, infants, and young children should be prioritized when allocating nets. However, sleeping space surveys reveal that heads of household sometimes receive priority over children less than five years of age when households have too few nets to cover all members.ConclusionsWhen asked directly, most net owners highlight the importance of allocating nets to the most biologically vulnerable household members. This is consistent with malaria behaviour change and health education messages. In actual allocation, however, factors other than biological vulnerability may influence who does and does not receive a net.

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Vouchers for scaling up insecticide-treated nets in Tanzania: Methods for monitoring and evaluation of a national health system intervention

Cited by 51 publications

References 24 publications

Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania

Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania

Integrated vector management for malaria control in Uganda: knowledge, perceptions and policy development

Decision-making on intra-household allocation of bed nets in Uganda: do households prioritize the most vulnerable members?

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