Community cooperatives and insecticide-treated materials for malaria control: a new experience in Latin America

Abstract

Background and objectivesInsecticide-treated materials (ITMs) are effective in substantially reducing the burden of malaria and other vector-borne diseases; but how can high coverage rates of ITMs be achieved and maintained? In south Mexico and on the Pacific and Atlantic coasts of Colombia 14 community-based cooperatives offering three different kinds of ITM services (sale of impregnation services; sale of impregnated nets; production of nets and sale of impregnated nets) were formed and supervised by a national health service (IMSS-SOLIDARIDAD, Mexico) and by an academic institution (the Colombian Institute of Tropical Medicine) along with local district health services. The objectives of this research were to analyse the processes and results of this approach and to identify the favourable and limiting factors.MethodsThe methods used for data collection and analysis were group discussions, individual and semi-structured interviews with users and non-users of ITMs, individual in-depth interviews with cooperative members and supervisors, checks of sales book and observation of impregnation services.ResultsCoverage with unimpregnated nets was above 50% in all study areas. The fastest increase of ITM coverage was achieved through the exclusive sale of impregnation services. Low-cost social marketing techniques were used to increase demand. The large-scale production of nets in two cooperatives was only possible with the aid of an international NGO which ordered impregnated bednets for their target group. A number of favourable and limiting factors relating to the success of ITM cooperatives were identified. Of particular importance for the more successful Mexican cooperatives were: a) support by health services, b) smaller size, c) lesser desire for quick returns and d) lower ITM unit costs.ConclusionsITM community cooperatives supported and supervised by the health services have good potential in the Latin American context for achieving and maintaining high impregnation rates.

Current strategies and successes in engaging women in vector control: a systematic review

“…Nine studies were retained from the original search, 6 15 36 44–47 52 54 and 14 were added from forward and backward snowballing. 16 17 37–43 48–51 53 Ten studies were conducted in low-income countries as defined by the human development index, 6 15 37 40–45 50 eight in medium-income countries, 16 36 38 39 46 48 53 54 four in high-income countries 17 47 49 51 and one in multiple countries of varying incomes. 52 Three studies discussed involving women in vector control programmes for human African trypanosomiasis (HAT), 42 43 50 8 discussed dengue, 16 36 39 46 47 52–54 10 malaria, 15 17 37 38 40 41 44 45 48 49 1 schistosomiasis 51 and 1 water-borne diseases including both malaria and schistosomiasis.…”

“…Six programmes were identified that engaged women in micro-enterprise to create and/or provide sustainable delivery of vector control products. 14 15 17 40 41 59 Four of them were conducted in sub-Saharan Africa, 15 40 41 59 one in Latin America 17 and one in Asia. 14 All of the programmes were focused on malaria control.…”

“…14 All of the programmes were focused on malaria control. Five of the six were engaging women and in some cases men and women, 17 40 in either making, selling or treating insecticide-treated bed nets. 14 15 17 40 41 Of those, the Tupendane study in Tanzania also provided women with polystyrene beads to sell that acted as a layer to prevent mosquito development in latrines and septic tanks.…”

“…15 These differed slightly from the Mama Mosquito project being carried out in Senegal where women, generally over age 40, were trained on the proper procedures and safety protocols to administer indoor residual spray. 59 Several of the studies discussed the success of the programmes in terms of women being the primary holders of leadership positions in community-based cooperatives 17 and the ability of the programmes to provide affordable products and services for the communities in which they were engaged. 17 40 59 None of the studies provided head to head comparison with similar male-led programmes and long-term follow-up had not been undertaken.…”

Evaluation of a continuous community-based ITN distribution pilot in Lainya County, South Sudan 2012–2013

“…Community health workers or community leaders have been used to selling subsidized nets in Afghan refugee camps in Pakistan [ 19 ], in several communities in Latin America [ 20 ], and in social marketing projects in Kilombero, Tanzania [ 2 ] and Sofala and Manica Provinces in Mozambique [ 21 ]. Community-based organizations, such as committees or cooperatives, have been used for the same purpose in four areas in Kenya [ 22 ], and Mexico and Colombia [ 23 ]. All these examples show that a demand-driven ITN distribution scheme is feasible and acceptable to the communities, but using these approaches alone and without building on a previous mass campaign, ITN ownership only increases gradually [ 3 ].…”