POST 00774E: MEASLES CAMPAIGN AND ITN DISTRIBUTION
Follow-up on Posts 00763E, 00765E, 00767E, 00768E and 00771E
11 April 2005
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This posting continues the discussion on measles campaign and bednet
distribution with two contributions, both from colleagues of the IFRC. The
first is from Stefan Hoyer (mailto:[email protected]) or
(mailto:[email protected]) based in Zimbabwe. The second is from Jean
Roy (mailto:[email protected]) and contains an appeal for country
interventions data that should be well noted by those concerned.
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Dear colleagues,
Please find enclosed an extract of a recent presentation of the NMCP Zambia
(http://www.technet21.org/zambia3.ppt) which shows that despite all
laudable efforts of the many partners engaged in Zambia over the last
years, the only districts that achieved, indeed exceeded, the low Abuja
targets were the five districts which carried out the "Measles and malaria"
pilot campaign of 2003.
On this background it is saddening to read continued attempts to discredit
the simple and coherent idea of giving out ITNs to children under five at
the opportunity of receiving other live saving health services. It is wrong
to suggest that nets given out through the integrated approach are not
followed up or that they are simply "dumped" which seems to imply a lack of
targeting.
The counter argument that this "undermines" ongoing efforts to promote ITN
use is also wrong. As a matter of fact, social marketing and similar
efforts to strengthen bednet coverage through sales can be strengthened by
targeted, free distributions so long as they are well coordinated with the
longer-term projects and are perceived as promotional distributions.
Promotional free distributions are a regularly practised technique of
social marketing (PSI usually gives out 30% of condoms for free).
This principle was successfully tested in Zambia where in Kalulushi
district a 100% redemption voucher scheme was carried out in collaboration
with Netmark boosting the sales of Netmark supported private ITN outlets
while achieving equity among all socio-economic groups and rapid scale up
(ref. to 2nd presentation : http://www.technet21.org/zambia1.ppt).
The error lies in the notion that an abstract ideal of a "system" is more
important than actual service delivery. More concretely: millions of
children should continue to risk their lives while waiting for services
arriving through "the correct system" when this could be avoided on a
nation-wide scale within one week through another approach that is simply
declared "incorrect" on a matter of principle defying basic common sense.
What is nothing but a grave lack of judgement is then justified through
defamatory terms such as "Blitz" as if speaking of an act of war.
The upside down concept that following the "right means" is more important
than rapidly reaching the goal is not only absurd but quite dangerous as it
could increase child mortality by unnecessarily delaying the delivery of
live saving public health goods to children in danger.
Yours sincerely,
Stefan Hoyer,
Dr. S. Hoyer
Malaria Adviser for Africa for the International Federation of Red Cross
and Red Crescent Societies (IFRC)
c/o Harare Regional Delegation
Harare, Zimbabwe
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Dear Colleagues,
Christian brings up an excellent point.... the diversity of countries and
the increasing complicity in terms of malaria interventions, inputs and
actors in each country require more country knowledge and tailoring of
approaches. There are no "facile" solutions to say that mass free
distribution or social marketing or other schemes are appropriate. Each
country must now be looked at with great care. The advent of GFATM funds,
other partners, other donors, and NGOs present a welcomed but more complex
country scenario.
RBM needs to develop specific country sub-national databases indicating
donor inputs in order to guide new players and donors and to avoid
duplicative efforts. I'm happy to report that RBM is now seriously working
at developing a database that will provide donors and other actors the data
that is needed for appropriate decision making.
These country profiles will include sub-national info on coverage, donor
inputs and unmet needs for LLITNs.
Indeed there are many approaches and we must move forward in a studied and
intelligent manner. The days of massive national free distribution schemes
are probably very shortlived. However there are perhaps lots of
sub-national (district level) massive efforts still possible where the most
vulnerable are not accessing LLITNs. But we all need data to make these
decisions.
RBM will need input from all NGOs and donors to compile these country
profiles. Please send them data on your country interventions when they
request it to compile comprehensive country summaries that will eventually
help us all in making our programming and funding decisions.
Thank you
Jean Roy
International Federation of Red Cross & Red Crescent Societies,
Geneva, Switzerland
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