As 2015 draws to a close we would like to thank all who have supported and worked
with AMF this year as without donors, distribution partners, volunteers and pro
bono supporters we would not be able to do what we do in contributing to the fight
against malaria. Thank you!
Distribution update
We have just completed, or are currently carrying out, three distributions in Malawi
(Balaka
and
Ntcheu districts) and DRC (North Ubangi district) totalling 1.37 million nets,
protecting 2.5 million people.
Post-distribution net use check-ups
There are post-distribution net use check-ups just completed or ongoing
in four locations ensuring we have data on how the protection of communities changes
over time.
Future distributions
We have made significant progress with discussions in five countries requiring individually
between 2 million and 15 million nets for the period 2016 to 2018
and expect to make announcement in the first part of 2016.
We are aiming to secure a further US$50 million for the projects we are currently
considering.
AMF top ranked!
AMF has again been top-ranked by the three leading organisations 'dedicated to finding
outstanding giving opportunities'.
GiveWell has ranked AMF their
#1 charity, for the fourth time in five years, and recommends to donors:
Giving What
We Can has confirmed AMF is again a top-ranked charity for the fifth year
in a row.
The Life You Can Save has AMF as a top-ranked charity for
the fifth year in a row.
US$22.8m grant
We are absolutely thrilled to have recently been awarded a US$22.8m grant by Good Ventures, the San Francisco based
philanthropic foundation. We see this grant as transformational for AMF, allowing
us to support larger scale distributions.
We are also delighted to have received two US$1,000,000 donations from US based donors, who visited
one of our programmes and carried out detailed due diligence before making this
commitment.
A suggestion for the Christmas/Holiday season!
Donate
nets instead of gifts.
We send the recipient/s an email (on a date you choose e.g. 25th Dec) with your
personal message and a link to their 'gift page', allowing them to follow the progress
of their nets.
May we wish you a very happy and healthy 2016!
Rob, Andrew, Cath and Peter
|
The Life You Can Save (TLYCS) has updated its list of recommended charities and we are delighted to be included again.
TLYCS highlight in their review 'Why AMF is effective':
-
Designed for long-term impact
-
Proven results
-
Effective monitoring and evaluation
-
Economically beneficial
-
Cost-effective
-
Efficient
-
Exceptionally low overheads
Please do have a look at the two new engaging videos put together by TLYCS, What Will Your Impact Be and Where Will You Give (This Giving Season), which include music from Malawian musician Gasper Nali.
More: The Life You Can Save
|
We are absolutely thrilled to have recently been awarded a US$22.8m grant by Good Ventures, the San Francisco based philanthropic foundation.
We see this grant as transformational for AMF
It is the largest grant AMF has ever received and it will make a huge impact on fighting malaria, saving many lives, reducing illness and boosting economic growth.
It comes at an exciting time for AMF as we work to expand the scale of the projects we support to multiple millions of nets at a time, including helping countries close net gaps so that entire populations are protected.
Every single donation is important, no matter how large, in the fight against malaria
There is a huge gap between the funding available and the net need. We never forget that every $3 buys a net and protects two people when they sleep at night, potentially from the bite of a malaria-carrying mosquito.
There are now over 133,000 donations to AMF. Together we have built a community that will keep the fight against malaria high on the international agenda. We are aiming to secure a further US$50+m for the projects we are currently considering. Aside the occasional marvellous large donation, the overwhelming number of AMF’s donations are from donors giving less than $200 and we are incredibly grateful for every one of them.
Good Ventures announcement
|
The short answer is Asia (Thailand, Vietnam, China) and Africa (Tanzania, and in the past
Malawi).
There are a series of companies that supply nets who are all WHOPES Phase II approved (World Health Organisation Pesticide Evaluation Scheme). This
is the body that evaluates nets and designates individual products safe for use
after appropriate lab and field testing. They publish all testing results.
Vestergaard, who produce PermaNet nets, and Sumitomo Vector Control, who produce
Olyset nets, are two of the bigger manufacturers and they are the two organisations
from whom we have bought the majority of our nets so far. Vestergaard are a Danish company and Sumitomo a Japanese company and they both have offices in a number of locations around the world.
Purchasing decisions are based largely, but not entirely, on price.
Nets are effectively a textile so there are economies of scale in manufacturing.
Global demand means there are a relatively small number of facilities needed to
produce the number of nets required. Scale economies mean it would not be cost effective
to locate a manufacturing facility in all or most countries that have a high net
need. However, Africa-based location could reduce logistics costs, improve the speed of supply (shipping currently takes two months or so) and benefit the local economy.
Vestergaard and Sumitomo supply the majority of their nets from Asia, typically
Vietnam, Thailand and China. There are manufacturing facilities other than in Asia.
For example, there is a facility in Tanzania that is a joint venture between Sumitomo
and a local company. There are/were plans for other facilities in Nigeria and Ethiopia
but we are not current on the situation there.
The majority of the nets we have bought to date have been from Asia but we have
bought significant quantities from the facility in Tanzania and from a supplier
in Malawi. When we required 130,000 nets to protect 130,000 boarding school children
in Tanzania we purchased from the Tanzanian supplier. A further 150,000, 235,000 and 322,500 nets have been supplied from Africa.
Our first obligation is to protect as many people as we can with the funds we have
available. If the lowest price is therefore from Asian supply, that is where we
are likely to buy. However, we are conscious of assisting local economies where we can, so
if the difference between two quotes is marginal, an order can end up with a local
supplier.
See also a related post from 2011
|
|
Here is an update of the donations received by AMF in the first four months of our
financial year. Every donation we receive is extremely important as every net matters.
- Large donations
- We are thrilled to have received two US$1,000,000 donations from US based donors, who visited our program and carried out detailed due diligence before making this commitment. The first is from the Foundation for the Greatest Good and the second is from a donor who wishes to remain anonymous.
- A grant of £50,000 per year for five years from a foundation in the UK.
- $577,000 from a total of twelve donors in the US, Canada, UK, Germany and Austria.
- Individual donations through the website
- 12,444 donations (+89% on the same period last year) totalling $4,610,452 (+594%).
- Recurring donations
- 1,764 recurring donors currently contribute $101,000 per month as of November 2015.
We appreciate every donation, yet the fight to control and eliminate malaria remains a huge task. The projects we are currently assessing have a need well in excess of our funds: $99.6m is needed against $18.6m available.
We expect to make further announcements in the next several months detailing where the
nets we fund will be distributed.
Thank you to every single one of our supporters. You can see your 'real-time'
donations, updated automatically each
time a donation is made.
|
The data collection phase of the 12-months post-distribution net use check-up (PDCU) in West Kasaï is underway.
- Smartphones are being used for data collection (screenshots of the process, and instructional videos that may be used)
- Valuable lessons were learned in the 6-month PDCU survey regarding the order and structure of questions. This has been improved to ensure the specific data required is fully captured
- 170 smartphones being used by data collectors
- 12,800 households (5% sample) selected at random being visited unannounced across 578 villages in 8 health zones
- The data collection phase will take place from 7th to 30th November
The PDCU gives all relevant parties data about net hang up and net condition and can contribute to ongoing malaria control decisions. There are now indications that the use of smartphones in data collection brings cost and other efficiencies. We will report more fully on this in the months ahead.
|
The data collection phase of the 6-months post-distribution net use check-up (PDCU) in Dowa District, Malawi, is now complete. Five percent of households, randomly selected, across 33 health centre areas in the district are being visited, unannounced, to assess net use and condition.
The data will be entered in Malawi in the coming days and may be viewed as they are entered. As soon as all data have been entered we will 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.
Background: 396,900 LLINs were distributed in Dowa District in March to May and October 2015.
|
The data collection phase of the 12-months post-distribution net use check-up (PDCU) in Dedza District, Malawi, is now complete. Five percent of households, randomly selected, across 33 health centre areas in the district have been visited, unannounced, to assess net use and condition.
The data are now being entered in Malawi and may be viewed as they are entered. As soon as all data have been entered we will 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.
Background: 290,770 LLINs were distributed in Dedza District in September and October 2014.
|
Two reports, one in the journal Nature and another by the World Health Organisation, provide information on progress against malaria. Insecticide treated bed nets were responsible for 68% of the reduction in malaria cases.
- Malaria death rates have fallen 60% globally since 2000
- 663 million cases have been prevented in Africa over the past 15 years
- 68% of the reduction due to the distribution of a billion bed nets
- 22% was attributed to the treatment artemisinin
- 10% to spraying homes with insecticide
- The number of infections fell by 50% across the continent
- Africa still accounts for 80% of cases and 78% of deaths
- 13 countries that had malaria in 2000 reported no cases in 2014 while a further six countries had fewer than ten cases
"Bed nets were responsible for the vast majority of the decrease."
"...despite the progress, the job is far from done. A child still dies from malaria every minute in Africa."
"Eight African countries are aiming to eliminate the disease by 2020 including Namibia."
"We know how to prevent and treat malaria. Since we can do it, we must."
|
We have had a number of questions regarding our application to achieve DGR status in Australia and we are happy to share the following information in case it can assist other organisations considering their charitable status in Australia.
This is the process we followed to achieve DGR status:
- We applied to the Australian Charities and Not-for-profits Commission (ACNC) to be considered for Public Benevolent Institution (PBI) status. Application document; support document.
- PBI status was granted by the ACNC six weeks after our application was submitted. Our experience was the ACNC were super-efficient, thorough, and always helpful and courteous. We were impressed throughout.
- Once PBI status was granted we applied to the Australian Taxation Office (ATO) to be considered for a Deductible Gift Recipient (DGR) endorsement.
- DGR status was granted by the ATO four weeks after our application. Our experience was the ATO were efficient and always helpful and courteous.
The main difference between this application process and prior (unsuccessful) efforts was the application for PBI status to the ACNC rather than an Overseas Aid Gift Deduction Scheme (OAGDS) application to AusAid. We are happy to help with questions if contacted directly.
|
We are delighted to say AMF now has tax deductible status for donors in Australia!
AMF (Australia) has been granted Deductible Gift Recipient (DGR) status effective 04 August 2015 by the Australian Taxation Office so any donations made to AMF (Australia) on or after that date can be considered tax deductible by the donor.
Note: All online donations from Australian residents (as identified by the credit or debit card address being in Australia) are automatically to AMF (Australia). For those wishing to make donations by bank transfer or cheque, the relevant bank account and address information can be found on our donations page.
|
The data are being entered in Malawi now and may be viewed as they are entered. As soon as all data have been entered we will 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.
Background: Almost 154,230 LLINs were distributed in Balaka District in October and November 2013.
|
The key results from the post-distribution check-up (PDCU) of net use and condition six months after the mass distribution of 245,000 LLINs are:
- 94% of nets hung
- 57% in 'very good' condition, 36% in 'good' condition
9,100 households (5% of those that initially received nets) and 15,676 nets were surveyed.
These are strong results.
We publish the full PDCU results and the PDCU Report as well as the PDCU Planning Document on the Dedza distribution page.
|
AMF (Germany) has recently opened an in-country EUR account to allow German donors to more easily make donations by bank transfer. All donations by German citizens are tax-deductible as AMF (Germany) is a registered charity with donee tax-deductible status.
You can find more details on the our charity and tax-deductible status in Germany, and other countries, on our Charity Status page and details of ways to donate online and offline on our donations page.
|
Although this article is from 2002, it provides a useful overview on why malaria has the impact it does. It gives an insight, for example, into why it affects the education and work opportunities of women. While the number of deaths and cases of illness from malaria have come down over the last ten years through all the efforts of communities and the aid community, the content of this article is still very relevant today.
|
At any time during the financial year donors and other stakeholders can see our year-to-date financial numbers.
We are able to do this as an automatic system sits behind all funds movements - donations, expenditures and, from an accounting perspective, accruals - so we know our financial position at any time.
This information is available as a by-product of the automation of our financial systems, the benefits of which we have written about previously.
|
We have submitted an application to the Australian Charities and Not-for-profits Commission (ACNC) as we seek Deductible Gift Recipient (DGR) status. If granted, this would allow donors to make donations to AMF (Australia) and receive a tax deduction on their donation. We understand we can expect to hear from the ACNC in a matter of weeks although we do not know how many. As soon as we have news we will post an update.
|
Summary
AMF and Concern Universal, Malawi (CU) have accepted the Malawi National Malaria Control Programme’s (NMCP) invitation to assume responsibility for the district-wide net distribution re-coverage campaigns in Ntcheu, Balaka, Dedza and Dowa districts in 2018. These are the four districts in which the AMF/CU partnership has distributed nets in 2012, 2014 and will in all districts in 2015. This timing is consistent with the three year re-coverage cycle needed to keep affected populations protected from malaria-carrying mosquitoes when they sleep at night.
Forward planning benefits all partners
The planning horizon for NMCPs, so they can secure funds to protect populations at risk, is three to four years. Hence, these future distributions being considered now.
This timeframe allows AMF to plan and secure funding in good time. Having specific projects to present to potential donors can help secure funds.
It allows Concern Universal to better plan and manage staff knowing the projects they will be working on several years ahead. Staff can be engaged on a permanent, multi-year basis, rather than on a project basis and the team can develop specific experience to manage and deliver all aspects of a distribution with increasing efficiency.
The combination of a portfolio of four districts, with each having seven interventions across a three year period (a pre-distribution registration survey, a distribution and five six-monthly post-distribution check-ups), and the staggered timing of the distributions and other interventions, allows an efficient and cost-effective deployment of staff and other resources.
Extended contribution to malaria control activities
Currently, CU’s malaria control activities are focused on carrying out universal coverage net distributions and their follow-up, and monitoring malaria case rate data.
The continuity of involvement in these districts will allow CU to deepen collaboration with District Health Officers (DHOs) and their teams and assist in other areas of malaria control, for example with systems and capacity building. Working closely with health centre management teams may lead to improvements in malaria diagnosis and the accuracy of malaria data collected.
Context: AMF and CU’s ultimate aim
AMF and CU’s ultimate aim is for our support for malaria control not to be needed. This will be the case if malaria is reduced to a very low level and/or if a population at risk from malaria is able to buy the nets they need and free-to-recipient distributions are not required. Currently, neither are the case. Carrying out three or four cycles of mass distribution of nets, if done well, can play a major role in bringing down the level of malaria in a population so that either or both of these objectives can be met.
|
Our Financial Year ended yesterday at midnight and, as part of our commitment to efficiency, our annual accounts have been generated and are available to view on our Easier-to-understand accounts page.
We are able to show our pre-audit numbers within a few hours of the end of our financial year as we have now completed the automation of our financial systems which brings a number of benefits:
- Accurate management information - On any aspect of our finances at any time
- Improved transparency - For management, governance and audit purposes
- Improved efficiency - Minimal administrative input to prepare the accounts at year end (data is entered most working days during the year)
- Swift production of our annual accounts - Within 24 hrs of FY end i.e. once the closing balances on our accounts are known the next day
- Assisting our auditors - Swift availability of our draft annual accounts to give our auditors maximum flexibility in scheduling their work
- Keeping stakeholders up to date – Providing donors, trustees and other stakeholders with timely information on our financial status and performance
A further benefit is we now have real-time financials in our ‘Easier-to-Understand’ section of our financial information.
|
A separate Technology Report, with an executive summary, shares details of our, and our distribution partner IMA's, experience using smartphone technology for data collection.
Summary
Smartphones were used to collect registration information from all households (255,500) receiving nets in a universal coverage mass net distribution. This allowed a significant quantity of data to be captured directly in electronic form.
The process proved very effective overall.
- 91% of the nets distributed had data recorded electronically
- 96% of the household data records were without error
We consider this a very strong outcome. This was the first use of smartphone data collection in a challenging distribution environment. It is also a strong basis from which to build. It was not without problems but, importantly, demonstrated significant potential for future distributions. We intend to use the same data collection process in the next net distribution, adjusted to apply lessons learned.
|
The first post-distribution check-up (PDCU) of net use and condition is underway in West Kasai Province, DRC. 5% of households, randomly selected, across 5 Health Zones will be visited, unannounced, to assess net use and condition.
Our distribution partner IMA World Health is conducting the check-up. The data are being gathered using smartphone technology and will be published once received and formatted, along with a report.
The PDCU has four objectives. First, to act as a further mechanism of accountability by reconciling the nets found during the PDCU with those in the distribution data. Second, to provide data on the use and condition of the nets, from which we understand coverage levels. Third, to encourage communities to continue to use nets and achieve high levels of coverage. Fourth, to provide data to the District Health Officer (or equivalent) and his/her team that may contribute to decisions on further malaria control-related interventions such as hang-up reminder activities.
|
The data are being entered in Malawi now and may be viewed in real-time. As soon as all data have been entered we will 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.
Background: 245,489 LLINs were distributed in Dedza District in September and October 2014.
|
|
We have made good progress in the last two months and are now in the final stages of discussion with several significant distributions.
We have identified co-funding and distribution partners and details are being discussed with these partners and the relevant National Malaria Control Programmes (NMCPs)
We are planning new net distributions during 2015 to 2017. In several cases, where we are considering a particularly significant quantity of nets, we are looking at funding distributions in three phases:
- 2015/early 2016 - pilot distributions of between 100,000 and 200,000 nets
- 2016 - 1 to 2 million nets
- 2017 - 1 to several million further nets.
This strucutre has the benefit of allowing relationships to be established and developed with NMCPs and partners with whom we have not worked previously, and demonstrates AMF's support is long term.
It also allows us to manage risk and structure our support to provide an incentive to all parties involved to ensure the distributions run as agreed and are successful.
Reaching and finalising agreements - particularly this last stage - can take several months and there is always the possibility an individual agreement will not be finalised.
Our updates share as candidly as we can the progress made.
We consider potential distributions three years ahead as this matches the planning cycle of NMCPs and the advance period in which they seek commitments for support. There are also regions where distributions are needed on a shorter timescale, and we act to cover them. More information via Planning horizon and Allocating donations.
|
Dowa distribution of 396,900 nets, Weeks 1 to 3
Summary
- The distribution is currently underway, having started on 23 Mar 15
- Problems with transport delayed the distribution by a month
- The distribution is expected to be completed by the end of May
|
Everyone involved in malaria control has a fervent wish a malaria vaccine is found.
The following information is taken from an article that appeared in The Pharmaceutical Journal, 9/16 May 2015, Vol 294, No 7861/2, online | URI: 20068442, published online on 6th May 2015.
Summary
- The first candidate malaria vaccine to reach phase III clinical trials, RTS,S/AS01, is not as effective at protecting young African children against the disease as was hoped.
- Episodes of malaria reduced by just over a third (36%) in children who received three doses of RTS,S/AS01 plus a booster.
- Researchers who conducted the trial say the vaccine is still worth deploying because millions of children could benefit from vaccination in areas of high transmission.
- Others have said the assertion the vaccine may be worth deploying in some settings because it prevented large numbers of uncomplicated cases was controversial.
Detail
- Episodes of malaria reduced by just over a third (36%) in children who received three doses of RTS,S/AS01 plus a booster, and by 28% in children who did not receive the booster. Vaccine was less effective in infants. No significant protection against severe disease. Meningitis occurred more frequently in children given the vaccine.
- Researchers who conducted the trial say the vaccine is still worth deploying because millions of children could benefit from vaccination in areas of high transmission.
- Brian Greenwood, a researcher in tropical medicine at the London School of Hygiene and Tropical Medicine, and involved in the trial, says: “Despite the falling efficacy over time, there is still a clear benefit from RTS,S/AS01. Given that there were an estimated 198 million malaria cases in 2013, this level of efficacy potentially translates into millions of cases of malaria in children being prevented.”
- Adrian Hill, director of the Jenner Institute at the University of Oxford, says the assertion that the vaccine may be worth deploying in some settings because it prevented large numbers of uncomplicated cases was controversial. “There was no impact on malaria mortality and no significant effect on severe malaria: non-significant reductions of just 1% and 10% were observed in the children and infants studied over the full trial period using a three dose regimen. This is clearly lower than the efficacy of impregnated bed nets.”
- New evidence of a rebound in malaria susceptibility after vaccination was “worrying”, he adds. “After 20 months, vaccinated children who were not boosted showed an increased risk of severe malaria over the next 27 months compared with non-vaccinated controls. It should be possible to make the vaccine more effective in some settings, but that will probably increase delivery costs substantially.”
- The safety and efficacy of RTS,S/AS01 is being reviewed by the European Medicines Agency’s (EMA’s) Committee for Medicinal Products for Human Use (CHMP). An opinion is expected in the second half of 2015.
- If a positive opinion is obtained and the vaccine is pre-qualified by the WHO, malaria endemic countries can then decide whether to license and use the vaccine.
- The price of the vaccine has yet to be set. GSK committed to setting a price that covers costs of manufacturing the vaccine and a small return of 5% to be reinvested in R&D for next generation malaria vaccines.
|
|
The hundreds of thousands who have swum, run, skipped, knitted or jumped up and down on a pogo stick to raise funds for AMF have inspired Rob, CEO and Founder of AMF, to attempt his first marathon.
"This will be my first marathon - and at my advanced age probably my last! After a half marathon in October I am very much looking forward (I think) to doing the full distance and raising funds to buy nets to protect people from malaria. My motivation to get round all 26 miles and 385 yards is to add thousands to the millions already protected from malaria thanks to our fantastic group of donors across the world. I have set an ambitious target of £100,000 which would all be used to buy 50,000 nets to protect 100,000 people when they sleep at night. Heartfelt thanks for any support you can give."
To sponsor him or follow his progress: https://www.AgainstMalaria.com/RobsLondonMarathon2015
|
We have now passed the US$35 million mark - thanks to a donation from New Jersey, USA!
We are also about to achieve 110,000 donations. As always, our sincere thanks to everyone for their support and generosity.
|
We have updated the information describing potential and future distributions.
We are currently discussing nine distributions in eight countries. The total net requirement across these distributions is 30 million nets for distribution in 2015 to 2017. Of these 6 million are in 2015, 4 million in 2016 and 20 million in 2017. We are not in a position to fund all distributions so expect to fund all or a part of a sub-set of these distributions. For the majority of these potential distributions we have agreed co-funding partnerships in principle and for all are in discussion with National Malaria Control Programmes (NMCPs) and/or potential distribution partners regarding elements of accountability.
We are allocating US$19.6m, sufficient to cover approximately 6 million nets.
In addition, AMF has been asked by the Malawi NMCP to continue to support malaria control activities in the four districts of Ntcheu, Balaka, Dedza and Dowa in 2018. This is a 1.5 million LLIN, US$6m commitment. We have allocated a further 150,000 LLINs to support an immediate flood-related emergency need in Malawi and we have agreed appropriate elements of net tracking and accountability for these nets.
Note: We consider potential distributions three years ahead as this matches the planning cycle of NMCPs and the advance period in which they seek commitments for support. There are also regions where distributions are needed on a shorter timescale, and we act to cover them. More information via Planning horizon and Allocating donations.
|
We have now passed the US$32 million mark - thanks to a donation from Australia!
We have also just had our 106,000th donation. As always, our sincere thanks to everyone for their support and generosity.
|
Click on the image to view the GPS location of each of the 234,916 households that received nets
DRC is one of the most challenging countries in the world in which to distribute nets. Distances are vast, infrastructure is poor yet the malaria burden and the need for nets is great. More than 500 people die from malaria every day in DRC, the majority children under 5.
Bringing accountability to a distribution therefore faces additional challenges.
The most important initial ingredient is a distribution partner who shares a strong desire to distribute nets accountably. In DRC we work with IMA World Health.
A new ingredient is the smartphone. The contrast between this cutting edge technology and the environment in which it is deployed could not be more stark but the smartphone has the potential to be a powerful tool in the fight against malaria.
Its use is in data collection. Rather than using paper and pen to note down household details and record nets distributed, and then face the logistical challenge of aggregating in one place from distant locations the information on many, many pieces of paper (approximately 7,000 for a 676,000 net distribution) data can be uploaded to a computer and aggregated with relative ease for correction, verification and analysis. And sharing. This last point is important as information in electronic form can be easily shared facilitating transparent review by interested parties, including health leaders and programme funders – thereby delivering accountability.
Update on West Kasaï
The distribution of 676,000 nets in West Kasai, DRC was completed in December 2014.
We are currently reviewing the distribution verification data and post-distribution report with our distribution partner, IMA World Health, and expect to publish a full report in the next few weeks.
This distribution is the first that both parties have undertaken using smartphones to collect household-level data. We expect teething problems, as with any new introduction of technology, especially in a country such as DRC. However, we are undeterred by this, as the benefits of improving processes in this region are so significant.
Smartphones installed with a data collection program, created using open source software, were used to collect household-level data including how many nets were given to each individual household.
GPS coordinates were recorded for each household receiving nets and these data are being reviewed as one aspect of 'distribution verification' – ensuring nets were distributed to beneficiaries as intended.
We believe these data are a promising sign that smartphones could be a powerful and practical tool to help net distributions deliver operational efficiencies and high levels of project accountability.
|
The New York Times recently ran an article reporting that some anti-malarial mosquito nets have been used for fishing and other purposes in a coastal village in Zambia, an area where there are no AMF-funded nets.
Potential mis-use of nets is an important issue for anyone concerned with trying to prevent malaria. It is clear some nets were being used for fishing and, anecdotally, this is familiar to all who work in malaria control so it is not a new finding.
The most important issue is scale.
In AMF’s experience over ten years in several hundred distributions across Africa, the number of nets used in ways other than as intended is extremely small.
It would be wrong to ignore these situations and we work to discourage and stop any occurrence of nets being used in this way.
However, it would also be wrong to move from anecdotal evidence of nets being misused, to suggest it is a widespread practice having a material effect on the impact of the nets in preventing malaria. Nets are the most significant mechanism for protecting people from malaria, saving hundreds of thousands of lives every year, far more from illness. We do not believe that we should deprive people of their main defence against a deadly disease because of the risk that they might misuse their net.
However, AMF takes a number of steps to stop misuse. We believe that each of them has contributed to the success of our distributions.
- Malaria education is key. We work closely with local health officials, the front line health teams and the village and community leaders, to ensure the community is fully aware of the connection between sleeping under intact nets and preventing malaria.
- AMF uses extremely rigorous pre-distribution surveys to determine precise net needs, followed by independent checks when the nets are given out to ensure no nets are diverted away from households that need them.
- AMF conducts post-distribution check-ups to ensure nets are being used as intended every 6-months during the 3 years following a distribution. People are informed that these checks will be made by random selection, and via unnannounced visits. This gives us a data-driven view of where the nets are and whether they are being used properly. We publish all the data we collect: example here. This type of follow up work is currently unique to AMF, although we hope the practice will become more widespread where it is feasible.
At AMF, the extensive data we have collected verifies that the number of nets we have distributed that are used for fishing is immaterial.
Old nets that have outlasted their effectiveness in the fight against malaria may be made into footballs or other harmless objects and we do not try to interfere with this.
|
The data are being entered in Malawi now and may be viewed in real-time. As soon as all data have been entered we will 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.
Background: Almost 154,230 LLINs were distributed in Balaka District in October and November 2013.
|