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Can ITN distribution policies increase children's ITN use? A DHS analysis
Katherine Theiss-Nyland1, Jo Lines2, Paul Fine3
1Faculty of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Katherine.theiss-nyland@paediatrics.ox.ac.uk.
Malaria Journal
|June 10, 2019
Summary
Routine distribution of insecticide-treated nets (ITN) through antenatal care (ANC) and immunization (EPI) services significantly increases children's ITN use. Combined ANC and EPI distribution is more effective than ANC alone for improving ITN access and coverage.
Area of Science:
- Public Health
- Global Health
- Vector-borne Disease Control
Background:
- Insecticide-treated nets (ITN) are crucial for malaria prevention.
- Mass distribution campaigns have been the primary method for ITN distribution.
- The World Health Organization (WHO) now recommends routine distribution via antenatal care (ANC) and expanded programme on immunization (EPI) services.
Purpose of the Study:
- To investigate the impact of different ITN distribution policies on children's net use.
- To compare outcomes between countries with varying facility-based ITN distribution strategies.
- To evaluate the effectiveness of routine ANC and EPI distribution compared to no facility-based distribution.
Main Methods:
- Analysis of Demographic Health Surveys from 25 African countries.
- Categorization of countries based on national ITN facility-based distribution policies (ANC, EPI, or both).
- Examination of household ITN ownership and ITN use among children under five years of age.
Main Results:
- Household ITN ownership and children's ITN use increased with each additional routine facility-based distribution policy.
- An average of 54.0% of children slept under an ITN in countries with ANC and EPI distribution, versus 34.3% (ANC only) and 24.7% (no facility-based distribution).
- Linear regression indicated a 13% average increase in net use among children under five for each additional distribution policy.
Conclusions:
- Routine ITN distribution via ANC and EPI services is effective in increasing ITN ownership and use.
- Combined ANC and EPI-based ITN distribution offers greater benefits than ANC distribution alone.
- Facility-based ITN distribution strategies can help countries maintain and enhance ITN coverage.
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