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Published on: January 12, 2017
Integration of insecticide-treated net distribution into routine immunization services in Malawi: a pilot study
Don P Mathanga1, Elizabeth T Luman, Carl H Campbell
1Department of Community Health, College of Medicine, Blantyre, Malawi.
Objectives:
To determine the feasibility of distributing insecticide-treated nets (ITNs) through routine immunization services, to increase ownership and use of ITNs among high-risk groups, whereas maintaining or improving timely completion of routine vaccinations.
Methods:
Free ITNs were provided with timely completion of routine vaccinations in two intervention districts in southern Malawi for 15 months. Cross-sectional baseline and follow-up household surveys were conducted in the two intervention districts and one control district.
Results:
Insecticide-treated nets utilization among children aged 12-23 months roughly doubled in the two intervention districts and did not change in the control district. Timely vaccination coverage increased in all three districts. The percentage of children aged 12-23 months who were both fully vaccinated by 12 months and slept under an ITN the night prior to the interview increased from 10-14% at baseline to 40-44% at follow-up in the intervention districts (P < 0.001), but did not change significantly in the control district.
Conclusions:
This study is the first to evaluate the provision of free ITNs at completion of a child's primary vaccination series, demonstrating that such a linkage is both feasible and can result in improved coverage with the combined services. Additional studies are needed to determine whether such a model is effective in other countries, and whether integration of other health services with immunization delivery could also be synergistic.
