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Background Nigeria has the world’s largest malaria burden, accounting for 27% of the world’s malaria cases and 23% of malaria mortality globally. This formative study describes the operational process of the mass distribution of long-lasting insecticide-treated nets (LLINs) during a campaign program in Nigeria. Objective This study aims to assess whether and how digital data collection and management tools can change current practices and help resolve major implementation issues. Methods Qualitative data on the technical features and operational processes of paper-based and information and communication technology (ICT)–based systems in the Edo and Kwara states from June 2 to 30, 2017, were collected on the basis of documented operation manuals, field observations, and informant interviews. During the LLIN campaign in Edo State, we recruited 6 local government area focal persons and monitors and documented daily review meetings during household mobilization (9 days) and net distribution (5 days) to understand the major program implementation issues associated with the following three aspects: logistic issues, technical issues, and demand creation. Each issue was categorized according to the expected degree (low, mid, and high) of change by the ICT system. Results The net campaign started with microplanning and training, followed by a month-long implementation process, which included household mobilization, net movement, net distribution, and end process monitoring. The ICT system can improve management and oversight issues related to data reporting and processes through user-centered interface design, built-in data quality control logic flow or algorithms, and workflow automation. These often require more than 50% of staff time and effort in the current paper-based practice. Compared with the current paper-based system, the real-time system is expected to reduce the time to payment compensation for health workers by about 20 days and produce summary campaign statistics for at least 20 to 30 days. Conclusions The ICT system can facilitate the measurement of population coverage beyond program coverage during an LLIN campaign with greater data reliability and timeliness, which are often compromised due to the limited workforce capacity in a paper-based system.

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BACKGROUND While there has been growing interest in using Information and Communication Technology (ICT) for supply chain management in public health programs, there is not enough evidence or guidelines that describe the specific features, processes and consequences. OBJECTIVE The formative study aims to describe the operational process of a mass distribution of long-lasting insecticide-treated nets (LLINs) campaign program in Nigeria and discuss whether and how ICT technology can change the current practice and help resolve major implementation issues. METHODS Nigeria implemented LLIN campaign programs in six states in 2017. We collected qualitative data in Edo and Kwara states in June 2017 where the LLIN campaign was implemented with existing paper based system and a digital data collection and management tool respectively. We identified technical features and operational processes of paper and ICT-based systems based on the documented operation manuals, field observations, and informant interviews. We identified key program implementation issues in the three aspects: logistic issues, technical issues, and demand creation. Each issue was categorized by the expected degree (low, mid, and high) of change by the ICT system. RESULTS The net campaign started with micro-planning and training followed by a month-long implementation including household mobilization, net movement, net distribution and end process monitoring. The ICT system has the potential for improving management and oversight through user-centered interface design, built-in data quality control logic flow/algorithms, workflow automation, and challenges as those in the current paper-based system. In particular, it can better manage the issues related to the data reporting system and processes, which comprises significant staff time and effort in the current paper-based practice. CONCLUSIONS The ICT system can facilitate the measurement of population coverage beyond program coverage during an LLIN campaign with greater data reliability and timeliness, which are often compromised under limited workforce capacity in paper-based system. CLINICALTRIAL Not applicable.