A Tanzanian program to supply insecticide treated nets to prevent malaria in pregnant women successfully delivers the intervention to only 30% of women, but simple changes could increase effectiveness, according to an article http://www.cmaj.ca/embargo/cmaj090268.pdf in CMAJ (Canadian Medical Association Journal) www.cmaj.ca.
Insecticide treated nets have been shown to reduce childhood mortality by 17% in different areas in Africa, reduce infection with malaria parasites in pregnant women by 38%, and decrease the incidence of severe malarial anemia by 47%.
The study by researchers from the London School of Hygiene and Tropical Medicine in London, England and the Ifakara Health Institute, Dar es Salaam, Tanzania looked at a sample of 6198 households that participated in the Tanzanian National Voucher Scheme between 2005 and 2007.
The program targets pregnant women and infants by providing vouchers for nets to women at their first antenatal visit. However, the several simple steps involved in the program result in some attrition at each step, which cumulates in a lower success rate than desired.
The researchers suggest that process analysis is useful to identify how programmes can be improved. Nets pretreated with insecticide are now being delivered, rather than relying on the recipients to treat the nets.
Journal
Canadian Medical Association Journal