Results of Two Post–Distribution Studies for Mosquito Nets Distributed in Zambia

 Introduction

As a result of a grant received from the Against Malaria Foundation (www.againstmalaria.org), the Power of Love Foundation provided 1300 long lasting insecticide treated nets to people vulnerable to Malaria in Kapri-Mposhi (a rural area) in Zambia in September 2010. For a detailed report of the distribution activities click here. To find out if the nets were being used and maintained properly, we conducted two follow-up studies, one six months after the distribution and one eighteen months after the distribution. The results of these studies is reported here.

About the Distribution Event: Kapiri Mposhi is a small town in Zambia, located about 185 kms north of the capital city of Lusaka. Mosquito nets were distributed to people living in the Ndeke compound in Kapiri-Mposhi, and this compound has a population of 9360 people and 2722 households. The reason Ndeke compound was chosen was because its population is at high risk and vulnerable to Malaria, and too poor to afford bed nets. In addition, the government has been unable to provide free nets to the people here. Lastly, a high prevalence of HIV which compromises the immune system puts the community at a higher risk for malaria.

At the distribution in September 2010, 1300 people in the Ndeke compound in Kapiri-Mposhi were provided with nets and the number of direct beneficiaries was 2600 (as 1 net has 2 sleeping spaces). Distribution of nets took place between on September 10, 11 and 12, 2010 to comfortably accommodate all 1300 direct beneficiaries. At the event, beneficiaries were provided with a demonstration on the proper treatment, use and set up and maintenance of the mosquito nets and educated on malaria prevention.

Post Distribution Study 1 (Six Months after the Distribution)

A post-distribution survey was conducted in March 2011 to assess the impact of the nets distribution in September/October 2010. Staff from a local NGO in Kapiri-Mposhi interviewed 150 beneficiaries and the findings are as follows:
• Most people who received the mosquito nets are using the nets effectively. They have continued to use, and maintain the mosquito nets as they were instructed on the distribution day event. Those who were not able to maintain the nets went back to the local Clinic for assistance.
• In most cases, more than 2 people were sleeping under one net. In some cases it was observed that 4 to 5 people are sleeping under the net.
• Parents and guardians of children ensured that children were sleeping under the nets.
• For the 150 beneficiaries that were interviewed, a total of 484 people sleep inside the mosquito nets. This shows that on average more than 3 people are sleeping inside one net.
• Regarding Malaria cases at the government clinic: The number of cases of malaria decreased from 543 cases in the months of July/August to 232 cases in the month of November which is the beginning of the peak season of malaria in Zambia.
• Most of the people interviewed said that they are looking forward to another distribution so that the number of people sleeping under one net could be reduced.
• It was observed by the clinic staff that it was important to continue to educate people on the importance of prevention of malaria by keeping their houses clean and using clean water to drink. It is a good idea to hold malaria prevention and education camps regularly to reduce the number of malaria cases in the community.

Based on this first follow-up study we can conclude that the nets are being used effectively by the beneficiaries and that it is possible to reduce the incidence of malaria in Kapiri-Mposhi, Zambia.

Post Distribution Study 2 (18 months after the distribution)

A post distribution survey was carried out in April 2012, approximately 18 months after the original distribution in September/October 2010. The survey was administered to 100 beneficiary households in the Ndeke compound in Kapiri-Mposhi, Zambia. The goal of this study was to assess the mosquito net usage, condition of the nets distributed, and the need for nets in this community.

Based on the survey results we were able to draw the following conclusions:
1. Most of the beneficiaries are using the nets correctly with a few not using them in the proper fashion. Recipients of nets who were not using them in the correct manner were advised on the correct usage of the nets at the time of this survey.
2. The condition of the nets in the sampled houses was mostly very good. A few recipients reported that the nets were in a poor condition and this could be due to the fact that the nets were used over spring or metal beds. In a few cases, rats had made holes in the nets. In two households it was reported that the nets received were stolen.
3. The usage of nets is 98%.
4. The average number of people sleeping under one net is a little over 2. This implies that one net is helping prevent malaria for two people. We are happy with this result as this reduces the cost of malaria prevention.
Need for nets - The number of nets received per household is lower than the number of sleeping places in each household. Most households have 3-5 sleeping spaces, but received only one or two nets. This implies that the community will benefit from additional nets for each household.

Learnings from the Post-Distribution Studies

Some of the learnings of this study were:
• To better understand the impact of the distribution of mosquito nets, we would have liked to interview at least 25% of the beneficiaries. However, we did not have enough funds and staff to interview 325 people. At this time we are working with the government clinic, to help us collect information after the next distribution of nets
• In this study only direct beneficiaries were interviewed. After the next distribution, we would like to include community members (who were not direct beneficiaries) to find out their impressions about our program.

Conclusion

We are thankful to Against Malaria Foundation for partnering with us so that we could make this distribution event happen. The distribution of 1300 nets to 2600 people has gone a long way in reducing the incidence of Malaria in Kapiri-Mposhi, Zambia and educating the community members about prevention of malaria. The nets distributed are in good condition and are being used for malaria prevention by the beneficiary households.

We continue to provide nets in Lusaka and Kapiri-Mposhi, Zambia. An additional 1500 nets were distributed in 2011 and we plan to provide an additional 1000 nets and education on malaria prevention in September 2012.

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