Intended for healthcare professionals


Distribution of insecticide treated nets in rural Africa

BMJ 2009; 339 doi: (Published 02 July 2009) Cite this as: BMJ 2009;339:b1598
  1. Thomas P Eisele, assistant professor1,
  2. Richard W Steketee, science director2
  1. 1Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
  2. 2Malaria Control and Evaluation Partnership in Africa (MACEPA), PATH, Batiment Avant Centre, 01210 Ferney-Voltaire, France
  1. teisele{at}

    A range of delivery systems is needed to achieve equitable coverage

    A concerted effort is currently under way across sub-Saharan Africa to increase the distribution of insecticide treated nets to achieve the Roll Back Malaria target of 80% coverage of children and pregnant women in endemic areas by 2010.1 Views vary greatly on the best delivery strategy or mix of strategies for achieving such coverage, especially in poor rural populations at greatest risk of malaria.

    Delivery strategies in Africa are categorised as public, private, or mixed.2 Public strategies include community distribution campaigns, routine distribution through channels such as antenatal clinics, and a mixture of campaigns and routine channels. Publicly distributed insecticide treated nets are usually free or heavily subsidised. Private strategies are typically market based, with insecticide treated nets being sold to the public through private retailers, often at a subsidised price. Public-private strategies, such as the Tanzania National Voucher Scheme evaluated in the linked paper …

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