POST 00767E : MEASLES CAMPAIGN AND ITN DISTRIBUTION
Follow-up on Posts 00763E and 00765E
24 March 2005
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We continue the posting of the discussion on ITNand measles campaign with
two contributions. The first is from Mike Favin
(mailto:
[email protected]) of the Manoff Group in the United States
with two attachments. The following is a short second contribution from
Mark Grabowsky (mailto:
[email protected]) of the American red Cross
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Hi, Robert, Mark, et al.,
Just a few brief comments on the interesting exchange below. I do have a
bit of experience with bed nets, although neither in selling them via
social marketing nor distributing them free as part of campaigns. First I
definitely agree with Mark that the nets potentially have a tremendous
social benefit, and that distributing them via social marketing is not
going to get them into enough poor households.
My main concern with the nets, in fact, is not getting them into people's
homes -- which for programs with significant money ain't hard -- but rather
with appropriate use of the nets once they're there. We actually did a
recent review of these issues and some research (including trials) in
Zambia (see attachments). There are rampant problems with the wrong people
(ie fathers) sleeping under the nets, with lack of retreatment, with very
frequent washings, with nets poorly hung, with people using them only in
the high mosquito season (in fact mosquitoes in the drier season are more
likely to carry malaria), with people not using nets as intended but using
them for a prestigious decoration or to make wedding dresses, etc.
So my main concern is regardless of how nets get distributed, how will
people be given a good enough orientation and reinforcement about their
intended use? It seems to me that this is very unlikely to happen when nets
are given out en masse during campaigns.
That's it. You got my 2 cents.
Regards, Mike
-----------------------------------------
Our research shows that use (treatment, hanging up, sleeping under) is
independent of distribution method. It only correlates with wealth and
seasonality. Despite implications to the contrary, there is no "use"
advantage to social marketing over mass distribution. Our findings are that
social marketing tends to use a less expensive net that requires treatment
by the purchaser, and the rate of proper treatment of these nets is low
(about 40%). Mass, free distribution tends to use a more expensive LLITN
that does not require treatment so there is a built-in 40% advantage for
proper treatment.
Mark Grabowsky, MD, MPH
CDC Technical Advisor
American Red Cross
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