title: Design, implementation and evaluation of a national campaign to deliver 18 million free long-lasting insecticidal nets to uncovered sleeping spaces in Tanzania.
abstract: BACKGROUND
  Since 2004, the Tanzanian National Voucher Scheme has increased availability and accessibility of insecticide-treated nets (ITNs) to pregnant women and infants by subsidizing the cost of nets purchased. From 2008 to 2010, a mass distribution campaign delivered nine million long-lasting insecticidal nets (LLINs) free-of-charge to children under-five years of age in Tanzania mainland. In 2010 and 2011, a Universal Coverage Campaign (UCC) led by the Ministry of Health and Social Welfare (MoHSW) was implemented to cover all sleeping spaces not yet reached through previous initiatives.
  
  
  METHODS
  The UCC was coordinated through a unit within the National Malaria Control Programme. Partners were contracted by the MoHSW to implement different activities in collaboration with local government authorities. Volunteers registered the number of uncovered sleeping spaces in every household in the country. On this basis, LLINs were ordered and delivered to village level, where they were issued over a three-day period in each zone (three regions). Household surveys were conducted in seven districts immediately after the campaign to assess net ownership and use.
  
  
  RESULTS
  The UCC was chiefly financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria with important contributions from the US President's Malaria Initiative. A total of 18.2 million LLINs were delivered at an average cost of USD 5.30 per LLIN. Overall, 83% of the expenses were used for LLIN procurement and delivery and 17% for campaign associated activities. Preliminary results of the latest Tanzania HIV Malaria Indicator Survey (2011-12) show that household ownership of at least one ITN increased to 91.5%. ITN use, among children under-five years of age, improved to 72.7% after the campaign. ITN ownership and use data post-campaign indicated high equity across wealth quintiles.
  
  
  CONCLUSIONS
  Close collaboration among the MoHSW, donors, contracted partners, local government authorities and volunteers made it possible to carry out one of the largest LLIN distribution campaigns conducted in Africa to date. Through the strong increase of ITN use, the recent activities of the national ITN programme will likely result in further decline in child mortality rates in Tanzania, helping to achieve Millennium Development Goals 4 and 6.
authors.affiliation: Swiss Tropical and Public Health Institute, P,O, Box, 4002, Basel, Switzerland.
authors.forename: Sabine
authors.initials: S
authors.lastname: Renggli
authors.forename: Renata
authors.initials: R
authors.lastname: Mandike
authors.forename: Karen
authors.initials: K
authors.lastname: Kramer
authors.forename: Faith
authors.initials: F
authors.lastname: Patrick
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Brown
authors.forename: Peter D
authors.initials: PD
authors.lastname: McElroy
authors.forename: Wilhelmina
authors.initials: W
authors.lastname: Rimisho
authors.forename: Amina
authors.initials: A
authors.lastname: Msengwa
authors.forename: Ally
authors.initials: A
authors.lastname: Mnzava
authors.forename: Rose
authors.initials: R
authors.lastname: Nathan
authors.forename: Romanus
authors.initials: R
authors.lastname: Mtung'e
authors.forename: Rita
authors.initials: R
authors.lastname: Mgullo
authors.forename: Jane
authors.initials: J
authors.lastname: Lweikiza
authors.forename: Christian
authors.initials: C
authors.lastname: Lengeler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D057148:Insecticide-Treated Bednets / Q000600:supply & distribution*; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods* / Q000458:organization & administration*; D011247:Pregnancy; D013636:Tanzania; D055815:Young Adult