Keep-Up & the 60/40 Solution 40% Civil society making a difference Behaviour change communication 60% Donors, agencies, governments, drugs, nets, condoms, vaccinations…

What do these have in common? Smallpox eradication Spanish Flu Polio vaccine USA Global plio eradication Smallpox – bifurcated needle

Behaviour change at the community level ……………one house at a time Demand for vaccinations Proper bednet usage Proper drug intake (HIV/TB/malaria) Appropriate use of condoms No major corporation would launch a new product without advertising & preparing the market. Do donors, development agencies do this? …..the 40% solution Ensuring commodities impact on diseases

Federation Malaria Funding 2006 *If estimated 6 mil CHF in bilateral support from national societies included total is 21.6 million CHF for million for the 40% solution Nets for the 60% solution *

Keep-Up in 2006  Togo (completion of 2 nd year)  Mozambique (1st year)  Kenya (planning & training)  Niger (Hang-Up only)  Sierra Leone (planning & training) Assessments and discussions for 2007 Keep-Up programmes in: Ghana Liberia Rwanda Uganda

Togo RC Surveys and Reported data Pre Campaign 1st CDC Coverage Survey Jan nd CDC Coverage Survey Sept Keep-UP Togo RC Report (12 districts) June 2006 % families with ITN 5,9%62,5%63,8%76,6% % LLINs hanging 36.2%45,7%93,2% %<5 sleeping43,5%53,6%84,4% % pregnant sleeping 35,8%44,8%37,6% HH with <5+LLIN 90,8% What is happening in the non-RC districts? A challenge to others!! CDC Mortality Survey, Oct with support from CIDA & Canadian RC

Niger RC Surveys and Reported Hang-up data, 2006 Pre- Campaign 1st CDC survey Jan-Feb Hang-Up August nd CDC survey Sept-Oct LLINs in HHs with <5 year olds 6%69.9% Range % 87.4%70% Net hanging20.3%79.3%85.36% <5 yrs sleeping under any net38.4% % <5 yrs sleeping under LLIN15.4%76.5%54.93% All HHs with any net64.9%84.83%86.8% Pregnant women sleeping under any net 31% 88.92% Pregnant women sleeping under LLIN 11.3%48.21%

Mozambique RC Surveys and Reported Data Manica & Safala, Pre Campaign 2005 CDC Coverage Survey Feb Keep-Up Report ManicaSofala ManicaSofalaManicaSofala % HHs redeeming LLIN voucher 88.9% Activities begun in late No data to report. Volunteers trained. Plans formulated. % ITNs hanging previous night 48.1%47.6% 89.2%92.4% %<5 sleeping ITN 59.3%61.6% % pregnant sleeping ITN 39% HH with any net20.6%35.6% 55.1% 59.1% HHs with LLINs 51.5%48.5%

Sierra Leone RC Surveys and Reported data, 2007 Pre- campaign Admin. Report, Jan DataDyne Survey Feb Keep-Up Results LLINs to <5 year olds98.9%84% Dec Vol. Training Jan. 07 – Coach recruitment Feb Budget approved Mar Community activities begin <5 yrs sleeping under any net <5 yrs sleeping under LLIN10.3%51% All HHs with any net Pregnant women sleeping under any net 12.5%

Kenya Keep-Up in 2007 Pre-surveyCDC Coverage Survey Feb Keep-Up Report HHs ownership ITN40%53%33% more <5s need to sleep under nets Recruitment & training of volunteers completed. Districts & coaches selected. Baseline survey March 07 % HHs w <5s with LLINs67.5% % ITNs hanging previous night41.9% % <5 sleeping LLINs previous night 39.1%51.7% % pregnant sleeping ITN36.3% HH with any net66.9% HHs with LLINs50.7%

What have we learned? 1.Need serious consultant time for each country programme 2.In-country supervision & monitoring need to be standardized 3.More emphasis on denominators & numerators # of HHs assigned to volunteer # & % hanging/not hanging # &% <5s sleeping under # & % newborns up-to-date w. vaccinations Possible solution: Cheap mini-PDA ($1.00 each) for volunteers’ monthly round of HH visits.

Keep-Up estimated costs Sierra Leone Keep-Up (fully funded) Togo Keep-Up (fully funded) Ghana Keep-Up (seeking pledges for RC capacity development) Kenya Keep-Up (partially funded) Kenya tool development/material (partially funded) Mozambique Keep-Up (gap) (fully funded) Uganda Keep-Up (seeking pledges) Indonesia Keep-up (seeking pledges if PMI capacities available) 3 consultants (funding assurred for 1 consultant- seeking more) 180, , , ,000 50, , ,000 Campaign social mobilisation estimated cost Madagascar, Burkina Faso and other GFATM joint countries500,000 LLINs (HBC, Emergencies, Refugees) estimated cost 500,000 Tool development, workshops, training, curriculum etc. 200,000 Contribution to LLINs and distribution Indonesia (1.8 mil. LLINs) 9,300,000 Togo Keep-Up survey –12 RC districts if CRC/CDC not doing 150,000 Future Plans – 2007 (in USDs )

Malaria Programme - Country Support 2006 Niger GFATM, CRC, NorCross Malawi Op. Research, FinRC, CDC, ARC Sierra Leone LLIN procurement for CRC ChadRefugee camp KenyaLogistics/social mobilisation Angola/Nigeria/ Rwanda Funds from in-country donors Equatorial GuineaExxon-Mobil, ARC CambodiaCommunity child health/ARC Ghana/TogoSpecial coverage surveys

Hang-Up Keep-Up Soak-Up Thank you for your attention Don’t forget……………