National Malaria Control Programme, Ministry of Health and Social Welfare, PO Box 9083, Dar es Salaam, Tanzania.
Malar J. 2011 Mar 31;10:73. doi: 10.1186/1475-2875-10-73.
After a national voucher scheme in 2004 provided pregnant women and infants with highly subsidized insecticide-treated nets (ITNs), use among children under five years (U5s) in mainland Tanzania increased from 16% in 2004 to 26.2% in 2007. In 2008, the Ministry of Health and Social Welfare planned a catch-up campaign to rapidly and equitably deliver a free long-lasting insecticidal net (LLIN) to every child under five years in Tanzania.
The ITN Cell, a unit within the National Malaria Control Programme (NMCP), coordinated the campaign on behalf of the Ministry of Health and Social Welfare. Government contractors trained and facilitated local government officials to supervise village-level volunteers on a registration of all U5s and the distribution and issuing of LLINs. The registration results formed the basis for the LLIN order and delivery to village level. Caregivers brought their registration coupons to village issuing posts during a three-day period where they received LLINs for their U5s. Household surveys in five districts assessed ITN ownership and use immediately after the campaign.
Nine donors contributed to the national campaign that purchased and distributed 9.0 million LLINs at an average cost of $7.07 per LLIN, including all campaign-associated activities. The campaign covered all eight zones of mainland Tanzania, the first region being covered separately during an integrated measles immunization/malaria LLIN distribution in August 2008, and was implemented one zone at a time from March 2009 until May 2010. ITN ownership at household level increased from Tanzania's 2008 national average of 45.7% to 63.4%, with significant regional variations. ITN use among U5s increased from 28.8% to 64.1%, a 2.2-fold increase, with increases ranging from 22.1-38.3% percentage points in different regions.
A national-level LLIN distribution strategy that fully engaged local government authorities helped avoid additional burden on the healthcare system. Distribution costs per net were comparable to other public health interventions. Particularly among rural residents, ITN ownership and use increased significantly for the intended beneficiaries. The upcoming universal LLIN distribution and further behaviour change communication will further improve ITN ownership and use in 2010-2011.
2004 年全国凭证计划为孕妇和婴儿提供了大量补贴的经杀虫剂处理的蚊帐（ITN）后，坦桑尼亚大陆五岁以下儿童（U5）的 ITN 使用量从 2004 年的 16%增加到 2007 年的 26.2%。2008 年，卫生和社会福利部计划开展一项追赶运动，迅速、公平地向坦桑尼亚每一位五岁以下儿童免费发放长效驱虫蚊帐（LLIN）。
国家疟疾控制方案（NMCP）内的 ITN 小组代表卫生和社会福利部协调了这项运动。政府承包商培训并协助地方政府官员监督村级志愿者对所有 U5 进行登记，并发放和发放 LLIN。登记结果是 LLIN 订单和交付到村级的基础。照顾者在为期三天的时间里带着他们的登记券到村级发放点领取 U5 的 LLIN。五个地区的家庭调查在运动后立即评估 ITN 的拥有和使用情况。
九个捐助者为国家运动做出了贡献，购买和分发了 900 万 LLIN，平均每 LLIN 成本为 7.07 美元，包括所有与运动相关的活动。该运动覆盖了坦桑尼亚大陆的八个地区，第一个地区在 2008 年 8 月单独进行麻疹免疫接种/疟疾 LLIN 分发时被覆盖，从 2009 年 3 月到 2010 年 5 月一次一个地区实施。家庭一级的 ITN 拥有率从坦桑尼亚 2008 年全国平均 45.7%上升到 63.4%，区域差异显著。U5 中 ITN 的使用率从 28.8%上升到 64.1%，增加了 2.2 倍，不同地区的增加幅度在 22.1-38.3 个百分点之间。
一项充分利用地方政府当局的国家一级 LLIN 分发战略有助于避免医疗保健系统的额外负担。每顶蚊帐的分发成本与其他公共卫生干预措施相当。特别是在农村居民中，预期受益人的 ITN 拥有率和使用率显著提高。即将进行的普遍 LLIN 分发和进一步的行为改变交流将在 2010-2011 年进一步提高 ITN 的拥有率和使用率。
