Promotion and Scale-up of nets distribution for pregnant women and women delivering at health facilities in Liberia

Since 2014, VectorWorks with support from the U.S. President’s Malaria Initiative (PMI) and global malaria project, have been supporting and working with the National Malaria Control Program (NMCP), to conduct County Review Meetings to develop local capacity and promote peer-to-peer learning to improve and scale up continuous nets distribution at ANC and ID. In an in-depth-interview with the Bomi County Reproductive Health Supervisor (CHRS) Fatu Jebbeh Holmes said she has been overseeing up to twenty-five county health facilities for the last fifteen years. She explains, “I am the health facility to ensure these mothers are using the nets the correct way or are putting it over their beds the correct way but the lack of transport and assistance in monitoring and supervision, are major challenges that I have.”

VectorWorks Liberia Program Officer Patricia Tengen and Bomi County Reproductive Health Supervisor (CRHS) Fatu Jebbeh Holmes.
VectorWorks Liberia Program Officer Patricia Tengen and Bomi County Reproductive Health Supervisor (CRHS) Fatu Jebbeh Holmes.

Reproductive health supervisors and officers in Liberia gather together at VectorWorks supported County Review Meetings to increase peer-to-peer learning and improve long-lasting insecticidal net (LLIN) distribution. As part of the national malaria strategy, the long lasting insecticide nets distribution channels focus on antenatal care and institutional delivery (ANC/ID) facilities at the district and county level. Continuous nets distribution, and use by women attending these facilities help to reduce maternal, morbidity and mortality from malaria in pregnancy.

VectorWorks works with County Reproductive Health Supervisors and District Reproductive Health Officers, who face enormous challenges in their efforts to improve the health of their communities. Some of these challenges include staff shortages, lack of access to policy and decision makers, poor dissemination and communication of information, and management of nets supply chain. VectorWorks found that the officers in charge of the district health facilities are often the only constant personnel and end up managing an extensive list of tasks and roles. Inadequate tracking and reporting on distribution of LLINs is common and difficult to tackle with limited resources.

VectorWorks supported County Review Meetings provide a platform for the engagement and learning across ANC/ID facilities in Liberia. These meetings facilitate improvements in planning, implementation, and reporting for LLIN distribution. Since 2016, with VectorWorks support, five County Review meetings were conducted. A total of 34 County Reproductive Health Supervisors and District Reproductive Health Officers had opportunity to participate in the national Review Meetings and shared lessons learned, best practices, how they ensure proper inventory of nets, and methods for collecting and keeping data on nets distributed and demand. These national review meeting provide opportunities for participants to learn from one another and create a community of practice around the LLIN distribution programs. After attending four national review meetings, Ms. Fatu Jebbeh Holmes has witnessed the benefit these meetings provide. “We should always have quarterly meetings as a reminder to be vigilant on supervision. Whenever you are doing your distribution you should not be completely out of nets at the facility before making a requisition for more nets. Without nets to provide, you are [risking] the life of a woman and her baby.”

The attendance of one of the county logistician from River Gee at a County Review Meeting where he over emphasized on the importance of the consumption data of nets given to pregnant women and the baby offered a favorable outcome. These logisticians are responsible for distribution of nets from the county depots. The attendees at this meeting were grateful to have the presence of a county logistician because it ensures better communication around inventory and reporting constraints in LLIN distribution for ANC/ID facilities.

VectorWorks support of district and county health personnel help to build and strengthen the capacity of district and counties to better manage and scale up continuous LLIN distribution at ANC/ID facilities. As Fatu Jebbeh Holmes stated, these meetings “[encourage] us to have mosquito nets at our health facilities to save the lives of our mothers and our children.” For CRHS across Liberia the national meetings provide a supportive network that allows for on-going growth and peer-to-peer learning.

Jenna Fritz is a current student at Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Carey Business School working on her dual degree, MPH/MBA.

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