Ntcheu, Malawi - Strong continued net use and condition after 24 months
The Post-Distribution net use and condition Check-Up (PDCU) in Ntcheu, Malawi
, carried out 24 months post-distribution, has shown an 81% hang-up of nets with 49% still being in ‘very good’ condition (up to two holes of up to 2cms in size). These are strong results. The sample size was significant: 9,100 households and 19,000 nets, representing 7% of the initial nets distributed and at least 250 households in each health centre catchment area.
Equally as important as the initial coverage of a population with nets, is the continued use of the nets so they continue to protect a population and prevent malaria.
The challenging environments in which nets are distributed can lead to nets becoming damaged or worn out so the number of nets hung, and the condition they are in, will decline over time.
However, initial high levels of coverage, a community’s understanding of the importance of the use and good treatment of nets, as well as appropriate interventions by health leaders all contribute to optimising the impact of the nets.
Data showing the level of net use and condition allows an understanding of the actual net coverage as well as providing the District Health Officer (DHO) and Malaria Coordinator (MC) and their teams with information that can be helpful in deciding on additional anti-malaria related interventions and where to direct them. This is particularly valuable where resources are limited.
We track net use and condition via a series of ‘Post-Distribution Check-ups’ (PDCUs) every six to nine months that involves unannounced visits to a randomly-selected set of households across all health-centre catchment areas, representing 5% of those that received nets initially. This provides statistically significant and locally actionable information. It is time-effectively and cost-effectively gathered and collated through a partnership between AMF, the local distribution partner and the local health teams. The information is immediately available to local health leaders.
Malaria is the, or one of the, most significant health issues in the areas in which nets are distributed and nets are the most effective method of prevention. Understanding the level of net coverage in the extended period after a mass distribution, and working to sustain high levels of net coverage justifies in our view the modest investment of time and money in collecting this data.
‘Universal coverage’ is used here to mean all sleeping spaces covered. A goal of some mass distribution programmes is 80% initial sleeping space coverage. We, and our partners, believe higher levels of coverage should be the aim and are achievable. We present and colour code the PDCU data
on the basis that 90%, 85% and 80% coverage after 6 , 15 and 24 months represent a ‘very good’, and therefore the desired, outcome.
Malawi, Ntcheu District: net use assessment 24-months post-distribution
The 24-months post-distribution net use check-up (PDCU)
was conducted in Ntcheu District during December 2013/January 2014. 9,250 households across all 37 health centre catchment areas in the district were visited, unannounced, to assess net use and condition.
The data are bring entered now and may be viewed as they are being entered in Malawi.
As soon as all data have been entered we will also publish a summary of the results.
The specific nature of the data - at the health centre level - means the District Health Officer (DHO), health centre leaders, community leaders and other health workers are able to decide what targeted malaria control intervention might be appropriate in specific areas. In circumstances where health systems and resources are stretched, information that assists with targeted interventions can help with effective use of resources and that is the aim of this information.
US$22 million milestone passed!
We have now passed the US$22 million mark - thanks to a donation from Burbank California, USA - and also had our 80,000th donation too - from San Diego!
Our sincere thanks to everyone for their support and generosity and best wishes for 2014.
What Would You Do If A Stranger Handed You $100?
The Life You Can Save has offered thousands of dollars to strangers on the street and gave them a choice: they could keep the money and run, or hand it over to charity! See what happened in the video below and take part in their giving game too!
Nightmare: Malaria exceptionally well received and reviewed!
The Nightmare: Malaria game developed by Pysop Games has been exceptionally well received and reviewed! It was downloaded more than 160,000 times across 181 countries in its first ten days (wow!) and is now nearing a quarter of a million downloads, been featured in the iTunes US App Store and on FastCoCreate, and been reviewed by AndroidPolice.
See: iTunes App Store, Google Play store and Kindle Fire
Future distributions update
We are presently seeking funding of an additional $5m
to be able to fund fully those distributions currently being discussed and requiring a decision before the end of March 2014.
Tax-deductibility in Switzerland
Individuals in Switzerland can now make tax-deductible donations to AMF.
Effective Altruism Switzerland (EACH)
is able to receive tax deductible donations on behalf of AMF. This allows individual donors to benefit from full tax deductibility when donating a minimum of CHF100. The tax deductibility applies for total donations per year of up to 20% of the donor's gross salary. A small fee of a few CHF, and up to CHF20, is deducted by EACH to cover costs. There also may be a bank transfer charge. Any donation intended for AMF must be accompanied by email notification to EACH
and to AMF
making clear the donation is intended for AMF.
Nightmare: Malaria - launched!
Nightmare: Malaria is now available to download and play for free on your iOS and Android devices!
Our thanks go to EGG (Establishment for the Greater Good) and PsyOp who have created a fantastic animation, voiced by Susan Sarandon, and also a superb free-to-play game.
Visit the Nightmare: Malaria site to find out more.
Balaka, Malawi distribution - Completion date 7th December 2013
The final mop-up phase will begin shortly now the final number of nets required to fill gaps is known. 15 villages required additional nets (+4,845 nets) and 28 villages omitted from the initial pre-distribution survey have been added (+4,879 nets). The distribution phase will be completed by 7th December with 158,805 distributed to achieve universal coverage of the district of 370,000 people. Concern Universal, Malawi, our distibution partner, has done a terrific job working closely with the district health service in managing this distribution.
AM Update - 28 November 2013
Distribution update – taking longer than anticipated
We had hoped by now to conclude agreements to allocate the majority of nets we are currently able to fund. Despite our best efforts, however, we have not been able to do so.
This is because we have not been able to reach a net distribution agreement for a major, country or province-wide net distribution with an appropriate level of accountability and transparency.
As you know, these are key considerations for us as theft of nets at a material level can occur with large net distributions. If there were no, or limited, concerns over the potential material misappropriation of nets, it would be very easy to hand over funds for them.
This statement does not indicate those potential partners with whom we have been discussing potential distributions tolerate the theft of nets. It does indicate we have not been able to achieve an agreement that would give access to information, enabling us to independently verify that nets would be distributed as intended, so we could report that to donors.
Watch the developing world 'develop' in 3 minutes!
A fascinating - and perhaps surprising - summary of progress in the developing world. A brilliant, clear, 3 minute video.
says 'Most people think the problems in the countries in Africa are unsolvable. But if the poorest countries can just follow [this path] it is fully possible that the world will look like this in 2030. Then there will be no countries left in the box we once called 'the developing world'. But to ensure that happens we must measure... By measuring the progress in the once labelled “developing countries”, preventable child mortality can be history by the year 2030.
' We agree. With bednet distributions that help address the malaria problem, measuring means collecting data on net delivery and continued use, which also allows us to be accountable to donors as to how their donations are spent.
New layout of distribution tracking information
The layout is now clearer and more concise. Four sections follow the distribution timeline:
- Donations show those that specifically funded the distribution.
- Pre-distribution allows you to follow the work that goes on before a distribution takes place.
- Distribution provides reports of what happened.
- Post-Distribution follows subsequent net use and malaria case rate data.
Accountability and transparency of how we spend your money are two guiding principles for AMF. We hope these additions help that.
US$21 million milestone passed!
We have now passed the US$21 million mark, thanks to a donation from London, England!
We also recently had our 76,000th donation too - from Melbourne, Australia. Our sincere thanks to everyone for their support and generosity.
We were approached several months ago by PsyOp, a digital agency based in Los Angeles and New York, who offered to create, pro bono, an animation to help in the fight against malaria. We challenged them to come up with an animation that could be used as a platform to help encourage a million people to give one net each. The result, including a free-to-play game, will be launched at the start of December.
See a preview of PsyOp and EGG's (Establishment for the Greater Good) impressive work.
Malaria cases reach a 40-year high in the United States
The Centers for Disease Control and Prevention (CDC) says 1,925 malaria cases were reported in the United States in 2011. This number is the highest since 1971 and represents a 14% increase since 2010.
CDC says 'Almost all of the malaria cases reported in the U.S. were acquired overseas. More than two-thirds (69%) of the cases were imported from Africa and for the first time, India was the country from which the most cases were imported. Cases showed seasonal peaks in January and August.'
More at: Malaria Nexus and CDC
Australia: Situation regarding application by AMF (Australia) for tax deductible status
Several hundred donors and potential donors in Australia have contacted us and asked to know our status as a potential tax deductible charity and the reason why our previous application was turned down.
AMF (Australia) does not currently have tax deductible status. Such status, if approved, would allow donors to claim a tax deduction on future donations to the charity.
We will shortly be submitting a further application to AusAid requesting consideration for this status. We understand we would expect to hear the result of our submission six months later. We will post the result of our application as soon as we know it.
AMF (Australia) applied for tax deductible status in 2009. AusAid turned us down for three reasons and told us the following:
- CRITERION (iii) It is a community-based organisation accountable to its membership.
In order to fully meet this OAGDS assessment criterion, [Against] Malaria Foundation (Australia) needs to report on all costs of the organisation’s operations, including fund-raising and administration costs, even though these may be covered by separate donations in cash or in-kind.
Our comment: We believe we did this. We have no cash costs in Australia and we reported in detail on the pro bono support we receive.
- CRITERION (vii) It and its overseas partners are both effective in conducting their activities.
In order to meet this OAGDS assessment criterion, [Against] Malaria Foundation (Australia) needs to demonstrate full interaction with its partners in all areas of the project cycle. In particular, it needs to provide evidence that it collects data from its partners to evaluate the impact of its specific programs and uses the results of such evaluations to strengthen future project activities.
Our comment: We believe we did so and comprehensively. We provided evidence and pointed to documents online.
- CRITERION (v) Its activities are focused on development and/or relief covering least one and preferably two years.
In order to meet this OAGDS criterion, [Against] Malaria Foundation (Australia) needs to provide documentation from itself or its partners consciously demonstrating a sustainable development paradigm.
Our comment: We believe we did so and comprehensively. The criterion says ‘development and/or relief’. It would seem to us that either or both cover well what we do.
We believed we had submitted a further application in 2010. AusAid told us they considered we had not. Discussions took place though 2011 and beyond. We were not clear how we could add information to our application.
Prior to submitting a new application we will a) try and understand if there is/are some structural aspect/s of what we do and how we do it that may mean we will not be eligible for such status and, if that is not the case b) we will work hard to try and address any concerns AusAid may have.
Detailed non-net cost budgets for 300,000 nets to Malawi
In February 2013, AMF agreed to fund the net and non-net costs for the distribution of some 300 - 400,000 LLINs in two districts in Malawi, Balaka and Dedza. We have now published detailed non-net cost budgets and will report on actual costs in due course. This information allows donors and others to see how we spend funds allocated to non-net costs. You can read about our approach to non-net costs on the website. The final number of nets to be distributed will be known when the household level pre-distribution assessment in Dedza is complete. The distribution of 149,500 nets in Balaka is underway.
First mid-distribution report available for Balaka district, Malawi
149,500 long-lasting insecticidal nets (LLINs) are currently being distributed in Balaka District, Malawi to achieve universal coverage - all sleeping spaces covered - to protect some 270,000 people. The first of several mid-distribution reports are now available on our website.
First-hand, independent view of the Balaka, Malawi distribution
When people, be they donors or not, contact us and ask to visit an AMF net distribution, be it to help out or view the process, we say yes. We are always supportive of people seeing for themselves what goes on with a distribution of nets.
Sophie and Richard Morgan chose to raise funds for AMF from January 2013 as an activity to accompany their return by car from Sydney, Australia to the UK involving driving from the south to the north of Africa. All funds they raised (http://www.AgainstMalaria.com/morgansafari
) were allocated to a distribution in Malawi and they were keen to visit the distribution to help distribute the nets they helped fund. Our distribution partner - Concern Universal, Malawi - was happy to help out and welcome them to the distribution team.
Sophie and Richard have written, with photographs, about their distribution experience
. It gives a good first-hand insight into what goes on during a distribution.
It is worth mentioning, no-one at AMF has met Richard and Sophie, although we hope to when they are back in the UK, and their blog post was unsolicited.
We will report in the coming months on the levels of net use and on malaria rates in Balaka District.
Net distribution started in Balaka district, Malawi
149,500 nets are now being distributed in Balaka district, Malawi
. All nets will be distributed by the end of October.
These nets will achieve universal coverage of all sleeping spaces in the district of some 388,000 people.
Pre-distribution work led by our distribution partner, Concern Universal Malawi, and carried out with the local government health teams, has involved visiting all 90,336 households in the district to establish net need per household. This allows an efficient, targeted distribution with each household receiving the number of nets each needs.
This pre-distribution activity allows significant engagement of community and health leaders in the net distribution process and associated malaria education elements. Community involvement is instrumental in ensuring an organised distribution and helping to achieve high levels of immediate net hang-up and sustained use.
Detailed distribution records, including household level data, will allow us to verify nets were distributed as intended. Independent supervision at the ‘moment of distribution’ ensures no nets are misappropriated.
The data collected during the pre-distribution phase will be used in the six-monthly post-distribution net use and condition check-ups, when 5% of households are selected at random and visited unannounced to gather net use and condition data. These (anonymised) data are made public, allowing us to report on the levels of net use achieved over time. The District Health Officer (DHO) and his/her team are able to use this health-centre level information to influence additional local malaria control interventions as they deem necessary.