The use of insecticide-treated nets (ITNs) is a malaria prevention strategy recommended by the World Health Organization (WHO). Nigeria has been distributing ITNs regularly during interventions since 2007. Intervention activities and assets are often tracked using paper or digital systems. In 2017, the ITN activity at Ondo University introduced a digital method to track training course attendance. Following the successful launch of the 2017 ITN campaign, subsequent campaigns plan to digitize other aspects of the campaign to improve the accountability and efficiency of ITN distribution. The COVID-19 pandemic has posed additional challenges to the ITN distribution planned for 2021, and adjustments have been made to planning strategies to ensure the event can be carried out safely. This article presents lessons learned from the 2021 ITN distribution exercise in Ondo State, Nigeria.
The campaign used a dedicated RedRose mobile app to monitor campaign planning and implementation, collect household information (including staff training), and track the transfer of ITNs between distribution centres and households. ITNs are distributed through a single-stage door-to-door distribution strategy.
The micro-planning activities are completed four months prior to the event. The national team and local government technical assistants were trained to conduct micro-planning activities at the local government, ward, health facility and community levels, including micro-quantitation of insecticide inoculation nets. The local government technical assistants then went to their local governments to provide mentoring, data collection and conduct familiarization visits for ward staff. The ward orientation, data collection and awareness raising visits were conducted in a group setting, strictly adhering to COVID-19 prevention protocols and guidelines. During the data collection process, the team collected ward maps (patterns), community lists, population details of each ward, location of distribution centres and catchment areas, and the number of mobilizers and distributors required in each ward. The ward map was developed by the ward in-charges, ward development managers and community representatives and included settlements, health facilities and distribution centres.
Typically, ITN campaigns use a two-stage targeted distribution strategy. The first stage involves mobilization visits to households. During the outreach, census teams collected information including household size and provided households with NIS cards indicating the number of ITNs they were entitled to receive at the distribution point. The visit also includes health education sessions that provide information on malaria and how to use and care for mosquito nets. Mobilization and surveys usually occur 1–2 weeks before ITN distribution. In the second stage, household representatives are required to come to a designated location with their NIS cards to receive the ITNs they are entitled to receive. In contrast, this campaign used a one-stage door-to-door distribution strategy. The strategy involves a single visit to the household where mobilization, enumeration, and distribution of ITNs occur simultaneously. The one-stage approach aims to avoid crowding at distribution centres, thereby reducing the number of contacts between distribution teams and household members to prevent the spread of COVID-19. The door-to-door distribution method involves mobilising and distributing teams to collect ITNs at distribution centres and delivering them directly to households, rather than households collecting ITNs at fixed points. Mobilisation and distribution teams use different modes of transport to distribute ITNs – walking, cycling and motorised – depending on the topography of each location and the distances between households. In accordance with national malaria immunisation guidelines, each household is allocated one dose of malaria immunisation, with a maximum of four doses of malaria immunisation per household. If the number of household members is odd, the number is rounded up.
In order to comply with the World Health Organization and the Nigerian National Centre for Disease Control and Prevention guidelines on COVID-19, the following steps have been taken during the distribution of this donation:
Providing delivery staff with personal protective equipment (PPE), including masks and hand sanitizer;
Follow COVID-19 prevention measures, including physical distancing, wearing masks at all times, and practicing hand hygiene; and
During the mobilization and distribution phases, each household received health education. Information provided in local languages covered topics such as malaria, COVID-19, and the use and care of insecticide-treated mosquito nets.
Four months after the campaign was launched, a household survey was conducted in 52 districts to monitor the availability of insecticide-treated nets in households.
RedRose is a mobile data collection platform that includes geolocation capabilities to track attendance at training sessions and monitor cash and asset transfers during mobilization and distribution campaigns. A second digital platform, SurveyCTO, is used for monitoring during and after the process.
The Information and Communications Technology (ICT) for Development (ICT4D) team was responsible for setting up the Android mobile devices before training, as well as before mobilization and distribution. Setting up includes checking that the device is working properly, charging the battery, and managing settings (including geolocation settings).
Post time: Mar-31-2025