Feedback on Field Assessment of LLIN Continuous Distribution in Zambia 13th February, 2014

Aspects of Implementation Assessed Coordination Logistics and supply chain Reporting and data collection Monitoring and supervision Training/ re-orientation Malaria messaging/ BCC

Challenges Viewed as separate activities for continuous and campaign but should be a continuum of activities mutually reinforcing for both beneficiaries and health system

ANC Distribution Limited storage space at district and HF levels Stock outs at district and HF levels Poor documentation of nets distributed Little or no monitoring/ supervision of distribution activities at HF level Little training on use of storage and distribution tools Disparities in malaria messaging

Who to give net to is ambiguous Under 5 Distribution Who to give net to is ambiguous LLIN distribution not captured in register Poor documentation of nets distributed

Community-based Distribution Distances from some communities to HF Criteria for issuing coupon to community member

School-based Distribution Limited storage capacity at district and school levels Selection of grades in primary school for net distribution Knowledge of malaria messaging at school level (SHN Coordinators)

Recommendations

General Committee for CD to be formed at national level Similar committees to be formed at provincial levels Provincial level team should be trained in the use of the NetCalc tool Draft guideline to be finalized and adopted by ministries and partners for LLIN CD

ANC & Under 5 Distribution Nets to be given to only children completing measles 1 vaccination (for <5 distribution) Improvise available registers for recording net distribution <5 years Re-orientation on use of tools at HF for net stocks and distribution Improve supervision of net distribution at HF and develop specific checklist for net distribution

ANC & Under 5 Distribution Re-orientation on malaria messaging Provide job aids on malaria messaging More efficient supply chain system to be instituted to get nets to HFs Thresholds and modalities for LLIN replenishment to be agreed and instituted

Community-based Distribution Identify storage hubs closer to communities for the redemption of coupons Agree on context-specific criteria for issuing coupons in addition to general criteria

School-based Distribution Nets to be moved to districts close to the agreed time of distribution of July Grades 1 and 4 agreed as selected classes in primary school for school distribution SHN and school head to be oriented on malaria messaging Provide guide on malaria messaging at school level