Step 11: Distribute Nets to Beneficiaries

Objectives

  • Ensure the intended recipients receive the ITNs.

Outputs

  • Beneficiaries receive ITNs.

  • Prepare items for distribution; prepare security measures, if necessary.
  • Distribute ITNs.
  • Pass on key messages.
  • Dispose of waste appropriately and have a mechanism for collecting/disposing safely of waste.
  • Complete record forms accurately.

  • Distribution will be very different, depending on the channel; review channel-specific guidance.
  • Waste management is an important, and often overlooked, aspect. If ITNs are procured with bags but provided to recipients without the bags, then these bags must be retained and should be managed according to WHO guidelines.
  • In some contexts (particularly school-based distribution, which acts like a mini-campaign), security may be a concern during distribution; this should be discussed and planned carefully before distribution.
  • Pass on key messages to the ITN recipients, including—
    • The ITN is for your family or other families who may need it; it is not specifically yours. Therefore, if you or others in your household already sleep under a net, but you have family members or neighbors who do not, please pass on the ITN.
    • Care for your net to make it last as long as possible. Wash it gently, check for holes and tears and repair them while they are still small.
    • Wash you net with a mild soap or detergent when you think it needs it.
    • Sleep under the ITN every night.
    • If your family needs additional nets, you can find them in the following places (list available channels).
  • Keep careful records of distributions. Record throughout the day as each ITN is distributed; do not ‘back-fill’ at the end of the day.

  • Distribute an ITN to every pregnant women at their first ANC visit (or later if they did not receive one), or during the appropriate vaccination for EPI programs (or later if they did not receive one).
  • Mark the recipients’ ANC or vaccination card to show that they received a net.
  • Record that an ITN was distributed in the ANC or EPI register.
  • Distribution will be on-going and in small quantities; it is unlikely there will be a need for security during the distributions.
  • The VectorWorks document, Guide to Health Facility-based Distribution of Insecticide-treated Nets, provides more detail on these issues.

  • In most cases, distribution will be made when a coupon recipient brings the coupon for redemption. ‘Distribution,’ therefore, has two steps: coupon distribution and redemption of the coupon to receive a net.
    • Community members approach the coupon distributor and ask for a coupon.
    • The coupon distributor should verify eligibility. This is easier for some criteria than others, and a household visit may be useful. Community household needs assessment form gives a template form that could be helpful.
    • Give a coupon if the recipient is eligible. Duplicates of the coupon make up part of the accountability system.
    • Give key messages; make the main focus on encouraging the coupon recipient to redeem it for a net.
    • At the redemption points, check the coupon and give an ITN, including a discussion of the key messages.
    • Add an entry to the distribution register and have the recipient sign.
  • Distribution will be on-going and in small quantities, it is unlikely that security will be needed during the distribution.
  • The VectorWorks document, Guide to Community-based Distribution of Insecticide-treated Nets, provides more detail on these issues.

  • Inform caregivers of the distribution plans well in advance, including the date of the distribution; some caregivers may want to send older siblings or adults if young pupils are receiving ITNs and are expected to walk home alone with the net.
  • Have each pupil sign their name against the distribution list when they receive their ITN.
  • Reverse logistics:
    • In many ways, school-based distribution is similar to a campaign distribution. It often is undertaken just once per year. ITNs are distributed on a single day to the target pupils. This means that there may be ‘left over’ at the school. Ensure that a clear plan is in place to deal with these ‘left over’ nets so they are not considered school property. The use of left over ITNs can have a significant role in accountability concerns, even if only a few are left at each distribution point because so many distribution points are involved.
    • Reverse logistics plans should see the left over ITNs taken to or collected by nearby supervising health facilities and absorbed into the health facility–based distribution.
    • Make forms available to ensure careful tracking and documentation of reverse logistics.
    • Make reverse logistics a focus of training and any sensitization meetings to ensure all involved are aware of the expectations and requirements.
  • The VectorWorks document, Guide to School-based Distribution of Insecticide-treated Nets, provides more detail on these issues.