The Winning Formula to Beat Malaria: IFRC World Malaria Day Report

This 7-page report, published by the International Federation of Red Cross and Red Crescent Societies (IFRC), discusses the organisation's experiences with distributing insecticide treated nets accompanied by "hang up" campaigns to ensure the nets are used. According to the report, there is growing scientific evidence to demonstrate that combining mosquito net distribution with follow-on "hang up" campaigns carried out by trained volunteers in the community significantly reduces incidence of malaria.

The report explains that combining distribution with follow-on support and training is especially crucial to reach the most vulnerable groups (such as those living in remote areas, refugees, and people affected by stigma and discrimination) who cannot be otherwise reached by mass media. Trained volunteers who live in the very same community as the beneficiary population and speak the same local language are ideally placed to help families overcome any social or cultural barriers that could prevent the effective hanging and use of nets.

The authors note that volunteers play a valuable support role during mass distribution campaigns, undertaking key activities to complement the distribution of nets, promoting better understanding of the risks of malaria, and providing more information on how to effectively prevent malaria. Before the campaign, the volunteers inform their local community that the distribution is taking place and where. The second action takes place during the campaign itself, with volunteers assisting with the logistics and distribution of the nets. During the hang-up phase, the same volunteers undertake house-to-house visits to make sure community members understand the malaria threat. They also check that families and community members know how to use the net.

According to the report, although there are some challenges measuring impact, a number of independent studies show a clear trend of the benefits of community-based bednet interventions. Results from the Centers for Disease Control and Prevention (CDC) survey on net coverage and usage in Sierra Leone (November 2007) show a 22% increase in net utilisation following a household visit by a community-based volunteer. These data complement existing data from Togo showing an increase in net utilisation in households that have received a visit from a community volunteer.

The report goes on to explain that to be able to focus attention on the most vulnerable populations in a country, volunteers need to have comprehensive knowledge of the community in which they work and live. Refugees and the most vulnerable (children under the age of five and pregnant women, populations without access to health services, people living with HIV, and stigmatised groups) need a tailored approach since they are more likely to be negatively affected by malaria than other members of the community. Cultural and social barriers can also prevent the correct use of the nets. According to a study from the Tulane University School of Public Health, there is evidence that some families who only own one net will have the head of the family sleep under it instead of the most vulnerable members of the household. Also, according to the same study, often children sleep in kitchens or a common room, which necessitates removing and rehanging the net daily, something that does not necessarily happen every night.

The report concludes that whether through mass mosquito net distribution campaigns or house-to-house activities to ensure nets are correctly hung, empowering communities is essential to reaching the most vulnerable households affected by malaria.