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Assessment |
Planning |
Implementation |
Monitoring & Evaluation |
| Demand |
Solicit help of experts with assessment: marketing
firms for formative research
Find out
current demand for and existing use of mosquito and malaria control
characteristics of consumer/client/user
demand at political and policy level, political commitment
current perception of the importance of malaria
present control measures needing improvement
Look at supply issues as they relate to demand |
Coordinate contribution of stakeholders (roles and responsibilities, mechanism for communication)
Mix messages and channels of communication (use formative research to define mix)
Use well-established processes for development and execution of demand creation (lessons learned from other sectors)
Create overall strategy and plan.
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Use what has been learned about the customer/client/user
Be ready to make adjustments: things change with time; a single approach won't last forever
View creation of an ITM culture as a long-term process
Convince policymakers that users come first
Don't create demand if supplies are not available (coordinate supply and demand)
Include policymakers in kick-off (include all players in start-up).
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Monitor demand creation (sales, repeat usage, outlets, distribution surveys)
Make programmatic changes based on monitoring information
Set key indicators: sales, utilization, consumer satisfaction
Carry out KAP studies of users to compare with baseline KAP
Decide what mechanisms will be used for information gathering in the planning
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| Accessibility |
Look at existing delivery channels both public and private for opportunities to piggy back
Take an inventory of the policy constraints or opportunities related to the import, manufacture, distribution, and promotion of ITMs, i.e., government policies re taxes, duties, registration
Look at the capacity of institutions at all levels to ensure availability of nets and insecticides
Look at availability at the country, regional, and community level (supply, manufacturer/ importer; current inventory)
Access consumer behavior in the marketplace re ITMs and similar consumer goods
Find out where nets come from, how they are being sold and distributed, and what distribution channels reach the target group.
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Take into account all aspects of planning (as given in guidelines)
Involve all appropriate stakeholders initially in coordination with the national malaria control program
Look at a large-scale programC even beyond national borders; provide guidelines for replication
Look at the programmatic framework and connections with other related programs and sectors
Develop an implementation plan.
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Provide a continuous source of technical support
Ensure adequate supply and re-supply of nets and insecticides
Prioritize projects based on epidemiology of malaria within a region or country
Use existing groups to distribute ITMs
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Incorporate feedback mechanism on rates of malaria morbidity
Cover costs for the initial purchase of nets and retreatment
Evaluate financing and subsidy schemes
Assess how subsidies for targeted groups might affect the unsubsidized markets
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Affordability |
Find out
volume and price of ITMs currently being sold
who is or is not buying them (if nets are available) and why (income, geography, risk groups)
current financing schemes
economic profile of target population
current subsidy patterns by target groups
Identify other household expenditure patterns and priorities
Gain an understanding of the policies and practices of the health system re distribution and availability of products
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Find out
whether ITMs are a national strategy or a local program
what financing schemes (at household and community level) will be used
Examine implications of dealing with nets as health products or commercial products
Forecast the growth of the ITM market and estimate its implications for price and logistics
Decide who should set prices and how they should be set: equity issue
If market sets price, consider subsidies
Set up a system of out-sourcing
Look at cost structure and how it will change over time
Articulate long-term vision for net/insecticide use
Decide who will pay for what and how long.
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Investigate credit schemes for poor populations
Examine lessons learned in cost-recovery from other ITM projects: Eritrea, Kenya, Tanzania
Promote public-sector role in assisting the poor and creating incentives for the private sector.
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Involve the consumer in monitoring and evaluation plans
Expand standard management information systems
Define indicators for effectiveness of ITMs at all levels.
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| Appropriate Use |
Find out how nets are being used
Achieve an understanding of the parameters of transmission in the target area: behavior of people, behavior of vector, environmental conditions
Examine operational conditions: policies and regulation, health and administrative infrastructure, commitment, resources available/ mobilizable.
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Decide on measurable, realistic goals
Identify target groups: Who needs to use ITMs?
Establish clear roles and responsibilities/partnerships
Develop training for various groups.
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Ensure that retreatment services are provided
Design IEC programs to supplement technical support.
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Link methods for monitoring use of ITMs at the local level with those at the national level of health information systems
Examine how many bednets are used, what percent retreated, and ultimately whether or not use of bednets and ITMs affect mortality and morbidity. |