Today, thanks to intensive malaria control efforts, most of Zanzibar’s population of 1.5 million people are free of the disease. Malaria cases are becoming more and more isolated, although 1,436 people fell ill on the island last year. In order to keep the number of cases low and prevent transmission, the Minister of Health, Hamad Rashid, and the Zanzibar Malaria Elimination Programme are working to ensure that all Zanzibaris have an insecticide-treated bed net (ITN) to sleep under.
On April 4, the Minister launched the Chandarua Kliniki program (Clinic Net). Pregnant women attending their first antenatal care visit, and infants getting their measles vaccination, will receive a free ITN at the health clinic. In addition, community members will soon be able to get a coupon from their local leader, called the sheha, and use it to pick up an ITN at the health facility.
Zanzibar’s ITN strategy is unique. While the islands have implemented three mass campaigns in the last 10 years to quickly scale up ITN coverage, during the years between mass campaigns, ownership tended to drop as the ITNs wore out. Zanzibar’s strategy now is to halt mass campaigns and rely on continuous distribution of ITNs to households, through the health facilities, to maintain consistently high levels of ITN ownership. The strategy targets the most vulnerable—pregnant women and infants—but also includes the community component, so that every family can get a new ITN when they need one.
“I urge everyone to get his or her net, to use it every night, and make sure you take good care of it,” said the Minister.
Deliveries of ITNs for pregnant women and infants began last October; since then, Zanzibar Central Medical Stores has delivered 58,665 ITNs to 190 health facilities across the islands. At a recent supervision visit, Zanzibar Malaria Elimination Programme (ZAMEP) ITN Officer, Riziki Suleiman, and VectorWorks Field Implementation Officer, Noela Kisoka, checked the recordkeeping at Mwera Health Facility.
“The process is going well,” said Kisoka. “The nurses recorded the client’s information in her ‘Clinic Card for Pregnant Women,’ and they punched it to show that it was her first visit and that she should receive an ITN.”
VectorWorks has collaborated with ZAMEP, the health management information system unit, Central Medical Stores, and Global Health Supply Chain project to develop dashboards that help visualize the number of ITNs delivered, distributed to beneficiaries; they can account for every ITN and coupon being distributed under the new program. The Central Medical Stores deliver the coupons and ITNs to health facilities and, using the existing reporting systems, they track them in the health management information system. “We are pleased to work with ZAMEP on this exciting project, which aims to make malaria a thing of the past,” said VectorWorks Chief of Party, Waziri Nyoni.
VectorWorks is a five-year global project, funded by the U.S. President’s Malaria Initiative, that aims to scale up vector control for malaria prevention through improved distribution of ITNs, optimal rollout of promising alternative vector control tools, and global policies that are informed by the use of monitoring and evaluation data. We are committed to a future where no one dies from malaria. VectorWorks develops and implements better ways to distribute ITNs, conducts research to inform evidence-based decision-making, and works to improve policy at the global and country levels.