World Malaria Day 2017

WORLD MALARIA DAY 2017

Illustrations © Maria Carluccio

Nets & Volunteers Are Changing Communities Have you ever wondered: how do mosquito nets get to the homes beyond the end of the road?

Follow along to learn how Episcopal Relief & Development and its partners in Ghana, with support from UK-based Against Malaria Foundation and the effort of thousands of trained local volunteers, are ensuring that families are educated and protected to end malaria for good.

Illustrations Š Maria Carluccio

Planning, Orientation & Training A good foundation is necessary for the success of any program, and with so many people involved in the distribution and follow-up activities, a lot of meetings need to take place! The program team meets and plans with the government’s Regional Health Directorate. National, regional and district supervisors are hired and oriented to the task.

Local volunteers are recruited and trained on how to build rapport when entering people’s homes to check on their nets, and how to collect the data that will show the impact of the program.

Illustrations Š Maria Carluccio

Household Registration & Coupon Distribution Trained community volunteers register households so that the correct number of nets will be waiting for them at the distribution point -- one net will usually cover two people, so for a household of four, you need two nets. Households receive a coupon with a serial number and the number of nets, which they will bring to the distribution point when it is time to collect their nets. The volunteer also helps the family understand the importance of collecting and using their nets to prevent malaria.

The household registration information is collected and sent for data entry.

Illustrations Š Maria Carluccio

Net Distribution At The Local Health Center After all households have been registered and have their coupons, and the net tallies for the community have been added up, the correct number of nets arrives at a set distribution point.

Households are welcome to arrive during open hours over the course of one week to present their coupon to a volunteer and receive the correct number of nets to take home. There is a one-month grace period for people to pick up their nets, just in case.

Illustrations Š Maria Carluccio

Presenting The Coupon, Receiving Nets

During the week-long net distribution, households bring their coupons and present them to a volunteer. The volunteer checks the serial number of the coupon and the number of nets against the counterfoil (coupon stub) retained by the program for records. The volunteer then tears open the packages of the correct number of nets (to deter resale) and gives them to the household to take home. The household keeps the coupon since there is helpful information on the back about how to install the net and why it’s important to sleep under it every night to prevent malaria.

Illustrations Š Maria Carluccio

Data Tracking Helps Show Success We know it’s true that the correct and consistent use of mosquito nets can reduce malaria -- but by how much? We hope to answer this question and more by tracking certain key bits of information covering the presence, condition and use of nets at the household level. After the month’s grace period is over, a round of validation is done on a sample of the participating households to ensure that the correct number of nets were received and made it home. Then, the tally sheets and coupon counterfoils from the distribution are collected and brought to a central location in Bolgatanga for data entry.

Illustrations Š Maria Carluccio

Monthly Home Visits By Trained Volunteers Every month, the trained volunteers who did the household registrations at the beginning of the program visit the households in their communities to check the presence and condition of the nets in people’s homes. They also provide continuing education on the importance of using the nets correctly and consistently to protect against malaria. This encouragement reinforces the “net culture� where people understand the importance of nets and will use them and replace them when they get worn out.

Illustrations Š Maria Carluccio

Six-month Post Distribution Check-Ups (PDCUs) Every six months, a group of enumerators surveys 5% of the total number of households to check the presence, condition and use of the distributed mosquito nets. Then, a second group of enumerators surveys 5% of that 5% to validate the first group’s findings. This activity ensures that the data is robust and reliable! In one district in the Greater Accra area, the PDCU activity is done on mobile devices to test this method of data collection, since it is instantaneous and requires less paper.

Illustrations Š Maria Carluccio

Data Entry, Reporting & Analysis Post Distribution Check-Ups (PDCUs) continue every six months for two-and-a-half years, which means a lot of data entry! This information is incredibly powerful, though, which makes it worth the effort. The Monitoring & Evaluation (M&E) team looks at net presence, condition and use along with monthly malaria case rate data from the local health directorates to see how big of a difference the program made in reducing illness and death from this preventable disease.

Illustrations Š Maria Carluccio

Volunteers Talk to Households About Integrated Health Based on the success of the NetsforLifeÂŽ methodology, which educates communities about the importance of using nets and then follows up after distribution to ensure their use, Episcopal Relief & Development is now using the iCCM (Integrated Community Case Management) approach to tackle malaria, diarrhea and pneumonia all together. Trained local volunteers talk to the households in their community about disease prevention and when to seek treatment, referring people to health services when needed.

Illustrations Š Maria Carluccio

Volunteers Reinforce The “Net Culture�

To End Malaria For Good

Trained community volunteers continue to talk to the households in their area about correctly and consistently using mosquito nets to protect against malaria. They also help people repair nets to prolong their use, and encourage people to replace old or damaged nets on their own rather than waiting for the next distribution campaign. Once communities see the impact of using nets, they understand their value and seek them out.

Illustrations Š Maria Carluccio

Results Sharing To Improve Program & Gain Support Sharing program results with diverse groups of stakeholders helps to improve the program’s function and management, and it also helps grow support for continuing and expanding program activities. The government sees that the program serves people well and is good value for money; the National Malaria Control Program sees that the distribution and follow-up methodology is sound and can be replicated in other areas; the trained volunteers see that their work is making a difference; and the participating communities see that they can take control of the health of their households and remain malaria-free.

Illustrations Š Maria Carluccio

A Roadmap To Ending Malaria For Good From pre-distribution preparation and planning through the distribution itself and post-distribution follow-up, the whole process is locally led and implemented. Episcopal Relief & Development spearheaded the development of the NetsforLifeŽ methodology and arranged the partnership with Against Malaria Foundation, but the Ghana Health Service, Ghana’s National Malaria Control Program and Episcopal Relief & Development’s local partner ADDRO are in charge of all training, net sourcing, surveying, distribution and follow-up. A program must have local ownership in order to be sustainable, and the road to ending malaria for good will take sustained effort on all our parts.