title: Best practices for an insecticide-treated bed net distribution programme in sub-Saharan eastern Africa.
abstract: Insecticide-treated bed nets are the preeminent malaria control means; though there is no consensus as to a best practice for large-scale insecticide-treated bed net distribution. In order to determine the paramount distribution method, this review assessed literature on recent insecticide treated bed net distribution programmes throughout sub-Saharan Eastern Africa. Inclusion criteria were that the study had taken place in sub-Saharan Eastern Africa, targeted malaria prevention and control, and occurred between 1996 and 2007. Forty-two studies were identified and reviewed. The results indicate that distribution frameworks varied greatly; and consequently so did outcomes of insecticide-treated bed net use. Studies revealed consistent inequities between urban and rural populations; which were most effectively alleviated through a free insecticide-treated bed net delivery and distribution framework. However, cost sharing through subsidies was shown to increase programme sustainability, which may lead to more long-term coverage. Thus, distribution should employ a catch up/keep up programme strategy. The catch-up programme rapidly scales up coverage, while the keep-up programme maintains coverage levels. Future directions for malaria should include progress toward distribution of long-lasting insecticide-treated nets.
authors.affiliation: Graduate School of Public Health, College of Health and Human Services, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-4162, USA. arsexton@gmail.com
authors.forename: Alexis R
authors.initials: AR
authors.lastname: Sexton
mesh_terms: D017954:Africa South of the Sahara; D000351:Africa, Eastern; D003695:Delivery of Health Care / Q000379:methods*; D006801:Humans; D057148:Insecticide-Treated Bednets; D008288:Malaria / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods*