Diapositive 1

1
Integrating ITN delivery and routine EPIMelanie
Renshaw UNICEF ESARO
2
Potential areas for collaboration in routine EPI
Delivery of treated nets to pregnant women
and/or children under 1 year at time of
vaccination e.g. DPT. TT and measles
3
ITNs through routine systems

• Malawi highly subsidised nets through MCH has
  led to a household coverage of 55
• Kenya 250,000 300,000 highly subsidised nets
  each month through MCH
• Angola free nets to pregnant women on 1st ANC
  visit, infants with DPT3 through static health
  facilities and outreach services
• Tanzania/Zambia/Ethiopia highly subsidised nets
  through vouchers to pregnant women

4
ITNs and routine EPI

• Advantages of ITNs alongside routine EPI
• Target group for both interventions is young
  children
• ITN distribution can piggy-back on logistics of
  EPI
• ITN distribution may increase EPI coverage
• Encourages sustained targeting of all new
  pregnant women and infants attending routine
  health services
• Encourages delivery of an integrated health
  package

5
ITNs and routine EPI

• Disadvantages of ITNs alongside routine EPI
• Increased burden on EPI distribution system
  bulky product
• Increased burden on EPI staff
• If routine attendance is low the most
  vulnerable target groups are missed

6
ITNs and campaigns

• Advantages of ITNs alongside EPI campaigns
• Target group for both interventions is young
  children,
• ITN distribution can piggy-back on logistics of
  EPI
• Potential exists to increase rural penetration
  and reach the hard to reach
• A campaign will rapidly raise ITN coverage
• ITN distribution may increase EPI coverage
• Elements of cost sharing between malaria and EPI

7
ITNs and campaigns

• Disadvantages of ITNs alongside EPI campaigns
• Increased burden on the distribution system -
  bulky product
• Increased burden on EPI staff and potential for
  confusion at the point of distribution
• Between campaigns, vulnerable groups will be
  missed
• May affect sustainable malaria delivery systems
• Increased potential for leakage to non-vulnerable
  groups

8
ITN delivery strategies routine and campaign

• ITN distribution via campaigns, such as measles,
  offer opportunities to rapidly increase coverage
  of ITNs
• These distributions are most effective when
  implemented as complementary to continuous ITN
  distributions such as through routine ANC or
  immunization services
• Distribution strategies are country specific and
  should be linked to national goals and objectives