More than 3 billion people- nearly half the world’s population- are at risk for malaria, a preventable disease spread by mosquitoes. Insecticide-treated nets (ITNs), are one of the most effective tools in preventing malaria and reducing deaths. From 2000 to 2015, national malaria control programs have distributed over one billion ITNs. In Sub-Saharan Africa, the number of people sleeping under an ITN has increased substantially from 5% in 2005 to 53% in 2015; yet much work remains to attain the goal of universal coverage. As the scale of ITN distribution increases, so does the need for effective methods to identify, prevent and mitigate fraud and ensure that the ITNs reach beneficiaries in need.
When nets don’t go where intended, we lose an important tool in the fight against malaria.
One way to assure bed nets are going to the right places is with technology. Catholic Relief Services has distributed more than 26 million ITNs to prevent malaria through its programs worldwide. Building on this experience, CRS is working with the national malaria control programs in the Gambia and Nigeria to use technology to improve the efficiency and effectiveness of mass distribution campaigns. How does this work? In Nigeria, two-person interview teams go from house to house and record the head of the household’s name, number of household members, GPS location and the interviewer’s name in their smartphones. The heads of each household will be given vouchers for ITNs. Each voucher is registered to the head of the household to ensure that the voucher can be traced back to each beneficiary. The voucher has location details, the distribution point and the pick-up date. If any anomalies indicate possible fraud, CRS can investigate the matter. To receive their ITNs, beneficiaries bring their voucher to the distribution site, where their voucher will be scanned in exchange for an ITN.
By using smartphones to track ITN distributions, any discrepancies can be traced to precisely where they occurred, which increases accountability. Fraud is reduced, ensuring that those who need ITNs receive them. In addition to reducing fraud, smartphones help to speed up the process of distribution. Entering data in a smartphone is weeks quicker than recording it by hand, and smartphones also eliminate any problems with illegible handwriting. Digital data allows for programs to respond to problems in real time. In addition, the use of geospatial data can help identify any households missed during the registration process and to select convenient distribution points.
In Nigeria, a pilot program provided preliminary results on other benefits from the use of technology in ITN distributions. Results indicated that geographic information systems (GIS) could be used to identify communities not included in registration and select convenient distribution points. The pilot program also had a 95% redemption rate.
The benefits of using digital devices in ITN distributions were also evident in the Gambia project in 2014. CRS distributed 941,821 nets and the project achieved 94% coverage. The use of technology also improved efficiency. A previous 2011 campaign employed 2,700 teams working for 13 days (35,100 team days). The 2014 campaign employed 100 teams working for 112 days (11,200 team days). Overall, the use of technology improved coverage and efficiency while reducing fraud. According to Reuters, the Gambia could become the first sub-Saharan African country to completely eradicate malaria. The smart use of technology to achieve and sustain high levels of ITN coverage across the country has contributed towards this achievement. The Gambia celebrated national eradication of malaria on July 11th, 2016.
Amanda Bristowe - Intern, Catholic Relief Services
Elizabeth Stierman - Business Development Specialist Sr, Catholic Relief Services