Nigeria’ drive to achieve universal net coverage campaign – two per household – just wrapped up its first effort with over 2 million LLINs for 21 of the 44 local government areas (LGAs) in Kano State. Distribution in the remaining LGAs will occur later. All the partners were on board, and many lessons were learned – some quite unexpected.Â This is the first step in distributing 22 million nets in 12 states before the end of 2009 and 60 million in all states by the end of 2010.
The scheme started at the household level with the provision of two net vouchers. People were told to present these at one of the 2-4 distribution points in their ward over the upcoming two weeks.Â UNICEF introduced a unique SMS tracking system to monitor the net distribution that provided clues where there more or less vouchers than expected and where efforts to increase or shift commodities were needed.Â This system apparently worked well in the rural areas, but complications arose in the urban communities.
There was a rush for nets at some distribution points with people fearing that supplies of something free would not be adequate, so the sooner one claimed his/her nets the better.Â In addition some people, variously termed traders and hooligans thought that this would be an ideal way to make a profit and raided distribution points, stealing the nets they could carry away.Â Some obverses termed what happened as a ‘riot’ or a ‘stampede’, while others spoke of teargas. Unconfirmed injuries were also rumored. Security was not adequate for this unexpected ‘net-frenzy.’
At a point the exercise was suspended for a couple days. Additional police were provided, and eventually those with vouchers were served.Â The LLINs were packaged kust like those already on sale in some shops, and so a suggestion for future distributions that would reduce the enticement of theft would be branding of those nets provided free by the malaria partners.Â Another suggestion is to use the community directed approach to distribute the nets by local volunteers right to the households.Â If vouchers can be distributed to the household, so can LLINs, and that way distributors would see the actual house and its inhabitants and could engage immediately in education on proper net use.
Net use is the big remaining question. People certainly rushed to get the nets, whether for legitimate needs or not. The question is whether a few months for now one will see these nets hanging on beds in the various households and see vulnerable groups – small children and pregnant women, actually sleeping under them.
Anambra State is gearing up to distribute nearly 1.8 million nets in June. Hopefully Anambra will have adequate community involvement, good distributor training, detailed supervision, strong security and culturally relevant health education to prevent ‘stampedes’ and ensure real universal coverage.