Community cooperatives and insecticide-treated materials for malaria control: a new experience in Latin America.
OBJECTIVE
Insecticide-treated materials (ITMs) are effective in substantially reducing the burden of malaria and other vector-borne diseases; but how can high coverage rates of ITMs be achieved and maintained? In south Mexico and on the Pacific and Atlantic coasts of Colombia 14 community-based cooperatives offering three different kinds of ITM services (sale of impregnation services; sale of impregnated nets; production of nets and sale of impregnated nets) were formed and supervised by a national health service (IMSS-SOLIDARIDAD, Mexico) and by an academic institution (the Colombian Institute of Tropical Medicine) along with local district health services. The objectives of this research were to analyse the processes and results of this approach and to identify the favourable and limiting factors.


METHODS
The methods used for data collection and analysis were group discussions, individual and semi-structured interviews with users and non-users of ITMs, individual in-depth interviews with cooperative members and supervisors, checks of sales book and observation of impregnation services.


RESULTS
Coverage with unimpregnated nets was above 50% in all study areas. The fastest increase of ITM coverage was achieved through the exclusive sale of impregnation services. Low-cost social marketing techniques were used to increase demand. The large-scale production of nets in two cooperatives was only possible with the aid of an international NGO which ordered impregnated bednets for their target group. A number of favourable and limiting factors relating to the success of ITM cooperatives were identified. Of particular importance for the more successful Mexican cooperatives were: a) support by health services, b) smaller size, c) lesser desire for quick returns and d) lower ITM unit costs.


CONCLUSIONS
ITM community cooperatives supported and supervised by the health services have good potential in the Latin American context for achieving and maintaining high impregnation rates.
Kroeger
Axel
A
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. akroeger@liverpool.ac.uk
Aviñna
Ana
A
Ordoñnez-Gonzalez
José
J
Escandon
Celia
C
D000818:Animals; D001290:Attitude; D001512:Bedding and Linens / Q000191:economics / Q000706:statistics & numerical data; D003105:Colombia; D003132:Commerce / Q000706:statistics & numerical data; D003140:Communicable Disease Control / Q000379:methods* / Q000458:organization & administration / Q000706:statistics & numerical data; D019058:Community Networks / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D003365:Costs and Cost Analysis; D009033:Culicidae; D006801:Humans; D007303:Insect Vectors; D007306:Insecticides; D008288:Malaria / Q000517:prevention & control*; D008800:Mexico; D009032:Mosquito Control / Q000379:methods* / Q000706:statistics & numerical data
D007306:Insecticides