POST 00778E : MEASLES CAMPAIGN AND ITN DISTRIBUTION

POST 00778E : MEASLES CAMPAIGN AND ITN DISTRIBUTION Follow-up on Posts 00763E, 00765E, 00767E, 00768E, 00771E and 00774E 18 April 2005 _____________________________________ Mike Favin (mailto:[email protected]) of the Manoff Group in the United States has found this story on BBC News Online. "Malaria Wedding Net Dress Decline : A campaign in Uganda to stop brides using cheap bed nets as wedding dresses appears to be having an effect." http://news.bbc.co.uk/go/em/fr/-/2/hi/africa/4393375.stm This posting contains three contributions. The first from Rebecca Fields (mailto:[email protected]) from AED in the United States writing to David MacGuire, Director of Netmark in the same organization, reminds us clearly of the positions of the two sides to this discussion. The second is David's reply (mailto:[email protected]). Thirdly, Robert Steinglass (mailto:[email protected]) from ImmunizationBasics in the United States, contributes further comments. _____________________________________ David, Currently, there is quite a bit of attention being given to the distribution of ITNs during mass measles campaigns. Some people--especially those who are major proponents of measles campaigns in the first place--are very enthusiastic about this approach. Others, e.g., Mike MacDonald, feel that it falls far short of what is really needed, in that the campaigns serve merely as a distribution mechanism while overlooking many other important program elements to get ITNs used and maintained correctly. Issues of social marketing of ITNs, and their commercial distribution have also come up in this debate. Robert has been in the thick of these discussions, so if you have any particular reactions or insights, I'm sure he'd greatly appreciate hearing from you. Rebecca ------------------------------------- Rebecca and Robert, We actually worked with IFRC in Zambia on a targeted subsidy scheme to get ITNs to mothers and their children during a vaccination campaign in Kalalushi. We used vouchers rather than nets, gave them to women to redeem in nearby outlets. There was over 97% redemption. The great thing about this approach is that it got the nets in the hands of vulnerable populations in a very targeted way while simultaneously helping to expand outlets into fairly rural areas. In principle I think this is an approach that could work. However, getting the vaccine teams involved in managing the logistics of a highly bulky product on a massive scale could detract from their primary function of getting kids immunized and could also discourage commercial expansion of outlets which is needed for sustainability. I would also agree with Mike that there is a general lack of understanding from the proponents of this approach in terms of the behavior change communication that is needed to ensure correct use. You can't just hand people nets and expect that they will understand why/how to use them. Another thing to consider is something that happened in Ghana where Rotary and ExxonMobil supported the distribution of nets during a vaccination program. The people loved it. However, when those in neighboring communities heard about it they demanded nets themselves. When they were told that no other nets were available some refused to get their kids vaccinated in protest. This was a story we heard from an MOH person who felt that it was ok on a small scale but unrealistic to think that nets could be handed out to everyone. It would end up being a logistical nightmare that could have a negative impact in the end, and would be very costly. If you want to discuss this in further detail I would be more than happy. David David McGuire NetMark Director Academy for Educational Development Washington, DC --------------------------------------- The campaigns have achieved impressive results. My biggest concern remains the support for follow-up in between these high-visible externally-funded and popular initiatives. You seem to assume that this support is a given. But look at what has been the experience in the field in immunization: after the polio or measles campaigns, the necessary support (technical, financial, communications, etc.) for strengthening the routine immunization program has not been forthcoming. As I mentioned earlier, the polio eradication program has never even adopted an indicator as part of their accelerated disease control program to track the performance of the routine program; and in fact they have resisted to do so. Campaign success instead is unfortunately measured by what happens to coverage during the campaign and not in between campaigns. The interest surrounding the campaign is used primarily to build up disease surveillance (a good thing), but when continuing outbreaks occur, it is the weakness of the routine system that is blamed! My point is that the malaria control proponents who are concerned with longer-term control must hold the feet of the campaigners to the fire (i.e., hold them accountable) and insist that negative consequences of campaign approaches are anticipated as best as possible and that measures are put in place before the campaigns to increase the likelihood of positive spinoffs from the campaigns for the sustainable longer-term control of malaria. What planning is being done systematically on a country by country basis (other than which country still needs which supplies and funds for tomorrow's campaign) to ensure that the capacity is being built and barriers are being overcome so that malaria will be controlled over time? Regards, Robert Robert Steinglass Technical Director IMMUNIZATION Basics JSI Research & Training Arlington, VA USA ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. 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