Bed net ownership in Kenya: the impact of 3.4 million free bed nets.
BACKGROUND
In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated.


METHODS
A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs) with attached global positioning systems (GPS) were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data.


RESULTS
In targeted areas, 67.5% (95% CI: 64.6, 70.3%) of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0%) of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7%) slept under an ITN during the previous evening. Nearly forty percent (39.1%) of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%).


CONCLUSIONS
The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels.
Hightower
Allen
A
Division of Parasitic Diseases and Malaria, Centers for Disease Control, Center for Global Health, Mailstop F22, 4770 Buford Highway, Atlanta, GA 30341, USA. awh1@cdc.gov
Kiptui
Rebecca
R
Manya
Ayub
A
Wolkon
Adam
A
Vanden Eng
Jodi Leigh
JL
Hamel
Mary
M
Noor
Abdisalan
A
Sharif
Shahnaz K
SK
Buluma
Robert
R
Vulule
John
J
Laserson
Kayla
K
Slutsker
Laurence
L
Akhwale
Willis
W
D002675:Child, Preschool; D034201:Computers, Handheld; D003625:Data Collection; D003695:Delivery of Health Care / Q000458:organization & administration; D005191:Family Characteristics; D005260:Female; D040362:Geographic Information Systems / Q000295:instrumentation; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D057148:Insecticide-Treated Bednets; D007630:Kenya; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D009032:Mosquito Control / Q000379:methods*; D010067:Ownership / Q000706:statistics & numerical data*