Long Lasting Insecticide Net Distribution Campaign

According to UNICEF, the C4D strategy was developed using findings from the 2007 Malaria Indicator Survey (MIS), as well as inputs provided by community stakeholders who participated in a "Triple A" process - a 3-step problem-solving method (Assess the problem, Analyse its causes, and initiate Actions to improve the situation). This participatory process involved key stakeholders engaging in an ongoing interactive cycle that repeats the problem-solving sequence at different times in the campaign period, leading to regular modifications and improvements in the approaches taken.

The communication campaign strategy included several key activities:

Training of distributors and their supervisors
A 10-day training for distributors and supervisors was conducted. The training focused on knowledge related to malaria and LLINs, functionality of bednets, proper usage and care of bednets, distribution process and logistics, specific roles and responsibilities of team members, data recording, interpersonal communication skills, and use of geographic positioning system (GPS) to map out households and areas where nets have been distributed. The distribution mode was pilot-tested in one village and modifications were made.

Training of community mobilisation agents (demonstrators)
A group of 10 community-based drama performers selected from local drama groups received a 2-day training about basic malaria knowledge, such as the definition, causes, prevention, symptoms, and detection of malaria. The training emphasised that the most vulnerable groups are children under 5 years of age and pregnant women. The information was drawn from UNICEF’s Facts For Life and other locally produced information material. The group created an interactive performance that portrayed messages about basic malaria knowledge, as well as demonstrated the proper use and benefits of using LLINs.

Training about follow-up data
Health Education Assistants, comprised of community health workers and members of the village health committees, received training on interpersonal communication and how to assess proper use of bednets using a house-to-house strategy. Their role was to check and assess knowledge and skills among the population and collect data on proper hanging, frequency of use, and care of bednets.

Community-based demonstrations
Demonstrations preceded bed net distribution in 33 communities, which were designed to prepare communities for and sensitise them about the upcoming mass distribution. In each village, demonstrators performed at local primary schools and during kgotlas, a public meeting where members of the community gather to discuss matters of interest for the community. The village traditional leader, also called the “kgosi,” presides over the "kgotla". The presentations were interactive - with performers engaging community members in a dialogue on issues related to malaria and benefits of using bednets.

Mass distribution of nets followed soon after community demonstrations in each location. During distribution, each household was also provided with a poster calendar with peak malaria months shaded in. Following distribution, Health Education Assistants and Village Health Committee members conducted follow-up. As a follow up of the Okavango pilot in 2009, about 20,000 ITNs were also distributed in Ngamiland, another malaria endemic district. In 2010, the project was scaled up to the five malaria-endemic districts (Okavango, Ngamiland, Chobe, Boteti, and Tutume), where 96,000 bednets were distributed by July 2010.

Malaria, Maternal Health

Malaria is one of the major public health problems in Botswana and is endemic in the northwest part of the country, mainly in five districts. According to the most recent Malaria Indicator Survey (MIS), in three of the malaria-endemic districts, 9.4% of households have at least one ITN. Only 6.5% of children under 5 years of age and 3.8% of pregnant women used an ITN to protect themselves from malaria. In response to this, Botswana has made the elimination of malaria a public health priority.

According to UNICEF, the ownership of LLIN in Okavango increased from 12.6 % to 91 % after the intervention and the usage increased from 5.3% to 40% (MIS 2007; Okavango Pilot Evaluation Report 2009). They credit the evidence-based C4D strategies as a driving force and important factor for the successful LLIN distribution campaign.

For more information, contact:
UNICEF
P.O. Box 20678
Gaborone
Botswana
Fax: + 267 395.1233
Tel: + 267 395 2752
gaborone@unicef.org