Insecticide-treated Nets (ITN)¶
Insecticide-treated nets (ITNs) have emerged as the most widely utilized and effective vector control (VC) intervention, contributing significantly to the substantial reduction in malaria cases across Africa in recent decades. These nets are specially designed to fulfill two crucial functions:
- Mosquito Repellent and Elimination: ITNs are impregnated with insecticides that not only repel but also eliminate mosquitoes upon contact. By deterring the insects from approaching the net, it diminishes the risk of mosquito bites.
- Physical Barrier: ITNs also serve as a physical barrier between mosquitoes and humans. This prevents infected mosquitoes from reaching and biting humans, thereby reducing the transmission of malaria.
ITNs are one of the two primary malaria vector control interventions recommended by the World Health Organization (WHO) for large-scale implementation.
Distribution of ITNs typically occurs through two main approaches:
- Mass Distribution: ITNs are distributed extensively to the entire population once every 2-3 years. This approach ensures broad coverage and aims to reach as many individuals as possible.
- Continuous Distribution: ITNs can be distributed consistently through various channels such as antenatal care services, child immunization services, or school-based distributions. By integrating ITNs into existing healthcare platforms, regular and continuous access to nets is provided to the target populations.
By employing these distribution strategies, the goal is to maximize the accessibility and usage of ITNs, ultimately reducing malaria transmission and its associated burden.
ITN Mass distribution campaign¶
ITN mass distribution campaign (ITN-MC) aims to provide widespread access to insecticide-treated nets (ITNs) for the entire population of a designated area. The primary objective is to ensure that every individual in the population has the opportunity to sleep under a net, thereby receiving protection against mosquito bites and reducing the risk of vector-borne diseases.
To effectively capture data from ITN campaigns, users can decide to either collect the single distribution events and households, or to aggregate the information on the area and the distributed bednets.
- Tracker Program: The "VC-ITN-MC - Household Register" tracker program enables the systematic registration of households on an individual basis. This program records the number of nets provided to each household, ensuring accurate tracking and distribution information.
- Event Program: The "VC-ITN Mass Campaign" event program enables the input of ITN campaign results into DHIS2. This program is utilized after the campaign has concluded, allowing for the documentation of campaign outcomes.
OR
- Aggregate Data Sets Combination: The combination of two aggregate data sets, namely "VC-ITN-MC - Microplanning Information" and "VC-ITN-MC - Daily Summary Form" facilitates the regular collection of data during the registration of households within the distribution area and throughout the actual net distribution process. These data sets are designed to capture information on a daily or weekly basis.
Tracker program VC-ITN-MC - Household Register¶
This program is designed to facilitate the registration of individual households before the campaign commences, as well as record the number of nets allocated to each household during the campaign. This data is instrumental in calculating indicators that cannot be derived from other programs, specifically those related to ITN access. By capturing this information, the program enables a comprehensive assessment of ITN coverage and accessibility, providing valuable insights into the effectiveness of the campaign in ensuring adequate protection against vector-borne diseases.
Tracker Configuration¶
| Stage | Description and Metadata |
|---|---|
| Enrollment | Initial step of the registration of the TEI, the household |
| Registration | The stage collects information on the household (i.e. sleeping spaces, registered population and the number of nets allotted). |
| Distribution | The stage collects information on the number of ITNs issued, the name of the person that received the net and the ITN brand. |
Tracker Details¶
Enrollment¶
The enrollment collects core information to identify the household, including its coordinates.
Registration¶
This stage captures data on the number of people living in the household, the number of sleeping places within the household and the number of ITNs allocated to the household based on national ITN allocation algorithms.
Distribution¶
This stage captures data on the number of nets provided to the household, the name of the person that received them (optional DE) and the brand of the provided ITN.
Program rules¶
This program does not have any program rules. However, if the number of nets allocated to each household is a defined function of the number of household residents or sleeping places, a program rule can be built to automatically calculate the number of nets that should be provided to the household.
Legends¶
This package contains three legends - ITN- People per net: to highlight places where the number of people per net is >1.8 in red and those where the number of people per net is ≤ 1.8 in green
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VC-ITN-MC - Performance (0-80, 80-95, 95+): to highlight progress. For example, to mark whether the proportion of ITN distributed is approaching those initially allocated or still far. The category ranges (0-80, 80-95, 95+) can be adjusted based on country targets.
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VC-ITN-MC - Variance: to highlight when two indicator values are different (red). For example, to highlight the difference between the estimated ITN remaining at the end of the day and the reported ITN remaining at the end of the day.
Program indicators¶
This program contains several program indicators which are used by indicators to calculate standard campaign outcome indicators. The full list is available in the Metadata Reference File.
Indicators¶
The indicators are grouped in the indicator group named “VC-ITN- Mass Campaign- Household tracker”. THe full list is available in the Metadata Reference File](resources/reference/VC-ITN-MC-HH.xlsx).
VC-ITN Mass Campaign - Event Program¶
Event Configuration¶
The event program facilitates the seamless input of ITN campaign results into DHIS2, serving as a valuable tool for documenting the outcomes of the campaign. It is specifically designed to be utilized after the campaign has concluded, ensuring efficient and comprehensive recording of campaign data.
| Sections | Description |
|---|---|
| Basic Info | Campaign's end date |
| Bed Nets brand | These section gather the main bednet brand distributed during the campaign |
| Population-level results | These sections gather data on the number of expected and registered people during the campaign |
| Household-level results | These sections gather data on the number of expected and registered households during the campaign |
| Bednet-level results | This section gathers data on the numbers of nets planned and distributed |
| Comments | Where to report the completeness of the event and eventual comments |
Data Elements¶
The full list of data elements is available in the Metadata Reference File.
Event Details¶
New Event Registration¶
The creation of a new event requires the selection of: - The “VC- ITN - Mass Campaign” program - The VC-ITN Campaign - the ID of the campaign. By default the package includes some examples such as complete single years (2019 or 2020) for when a campaign is conducted in one specific year, or longer periods (2021-2022) for when the campaign is conducted across years. The ID can however be any identifier of the campaign, such as name, code, year, sequential numbers, or a combination of these.
- The ITN distribution area from the Organization Unit (OU) hierarchy (this is the location where the net was distributed)
Basic Info¶
Bed Nets brand¶
This section only includes the main brand of the ITNs distributed in the area. If several different brands are distributed in the same area, more DEs can be added to the section to capture the number of nets distributed of each brand.
Population-level results¶
This section includes two DEs to capture the number of people expected to live in the distribution area and the number of people registered during the pre-campaign registration. All fields are mandatory.
Household-level results¶
This section includes three DE to capture the number of households expected to be present in the distribution area, the number of households registered during the pre-campaign registration and the number of households who received at least one net by the end of the campaign.
Bednet-level results¶
This section includes two DEs to capture the number of bednets planned to be distributed and the number of bednets distributed in reality by the end of the campaign.
Comments and Status¶
Program Rules¶
This program does not have any program rules.
Analytics¶
Program Indicators¶
The list of PI is available in the Metadata Reference File. Some of the PI simply capture the value of a DE while others calculate the percentage of nets distributed of those plans, of households benefited of those registered and of people at risk benefit of those registered. The list of PIs can be expanded depending on local analytic needs.
The calculations in the screenshot below are visible directly from the event capture app and provide the key insights about the campaign under registration.
Legends¶
This program includes one legend to be used in the visualizations. VC-ITN People per net which creates two categories in the people per net indicator. Below 1.8 people per net (green good net coverage) and above 1.8 people per net (red, poor net coverage). Some countries may use the threshold of 2 (instead of 1.8). In this case the legend threshold should be adapted accordingly.
Visualizations¶
The ITN campaign results dashboard (VC-ITN-MC) has four visualizations.
| Item name | Title | Type | Comments |
|---|---|---|---|
| ITN-MC-001 Coverage | ITN coverage | Map | This map shows the number of people per net distributed resulting at the end of the mass campaign.It allows to analyze inequalities across areas and identify gaps. It is configured to show the map for a specific year, if a campaign was conducted across years, please select the Period type “Start/end dates” and select the start and end date of the campaign. |
| ITN-MC-002 Distribution | ITN- Distributed bednets | Map | This map shows the total number of bednets distributed per area by the mass campaign. It is configured to show the map for a specific year, if a campaign was conducted across years, please select the Period type “Start/end dates” and select the start and end date of the campaign. |
| ITN-MC-003 People/bednet | People per bednet | Bar plot | A bar plot showing the number of people per net resulting after net distribution in each distribution area. select the Period type “Start/end dates'' and select the start and end date of the campaign. It is configured to show the bar plot for a specific year, if a campaign was conducted across years, please select the Period and then select the campaign ID category. |
| ITN-MC-004 Summary | Summary of ITN campaign results | Table | Provide a summary of the campaign results for the different distribution areas. Users can use this table to compare the results of different campaigns and understand if new campaigns are performing better than older ones. It is configured to show the bar plot for a specific year, if a campaign was conducted across years, please select the Period and the select the campaign ID category. |
Combination of aggregate datasets: VC-ITN-MC - Microplanning Information and VC-ITN-MC - Daily summary form¶
Acknowledgement¶
This toolkit was created originally by Population Services International (PSI). The WHO has harmonized it to follow the naming style of other DHIS2 modules and made some modification to program indicators and dashboards.
Data set VC-ITN-MC - Microplanning Information¶
The data set is designed to capture crucial information during the ITN distribution campaign. It primarily focuses on estimating the number of households and individuals residing in the distribution area, facilitating a comparison of the campaign's progress against predetermined targets. However, it is important to note that this data set should be completed only once at the beginning of the campaign.
In instances where countries or organizations already have population estimates stored within their DHIS2 instance, there is no requirement to install this particular data set. Instead, they can utilize their existing estimates, eliminating the need for duplication. If multiple ITN brands are being distributed within a single distribution area, additional data elements can be incorporated to capture information specific to each brand. This allows for comprehensive tracking of different net brands throughout the campaign.
Data set VC-ITN-MC - Daily summary form¶
This data set is split in two sections: The first should be completed during household registration before starting ITN distribution, whereas the second should be completed during the distribution of ITNs. Both sections are configured to be completed daily but the frequency can be adjusted to meet the data collection needs of the country/institution.
The first section (“Registration”) should be completed with information pertaining to the households and population present in the distribution area being registered. This involves capturing specific details such as the number of individuals, the count of available sleeping spaces, and the composition of households based on different sizes (e.g., 1-2 people, 3-4 people, etc.). Additionally, the data set should include the number of ITNs found among the registered population.
The number of ITNs allocated to the registered population is typically calculated using algorithms specific to each country. These algorithms aid in bednet quantification, ensuring an appropriate allocation of ITNs based on factors such as population size, household composition, and other relevant considerations. The allocated nets will therefore represent the number of nets that the registered population should theoretically have based on the household composition and the number of people per net as per national guidelines.
The distribution section should be completed as ITN is distributed. It contains the following data elements: - ITNs prepositioned: ITNs sent from the central level to the distribution area on that day. - ITNs opening balance: ITN available for distribution at the beginning of the distribution day. - ITNs issued: ITNs given to the population during that day. - ITNs received: ITN received from other distribution areas during that day. - ITNs redistributed: moved from this to other distribution areas (reallocated) during that day. - ITNs lost: lost or stolen during the day. - ITNs stock on hand: ITN left at the end of the day. - Households issued ITNs: number of households that received ITNs on that day.
The diagram below explains the flow of ITNs to illustrate the meaning of the different data elements.
Indicators¶
They are all grouped in the indicator grouped called “VC-ITN- Mass Campaign- Daily summary”
Special considerations¶
These documents outline three distinct options for collecting data during an ITN campaign. In cases where different options are employed in different regions or areas within a country, the collected data can be consolidated using indicators.
The distribution section of the “Daily Summary Form” could be also handled by the LMIS modules available in DHIS2 as they provide the key information on the transaction of medical items.
Analytics¶
Legends¶
This module contains three legends: - ITN- People per net: to highlight places where the number of people per net is >1.8 in red and those where the number of people per net is ≤ 1.8 in green - VC-ITN-MC - Performance (0-80, 80-95, 95+): to highlight progress. For example, to mark whether the proportion of ITN distributed is approaching those initially allocated or still far. The category ranges (0-80, 80-95, 95+) can be adjusted based on country targets. - VC-ITN-MC - Variance: to highlight when two indicator values are different (red). For example, to highlight the difference between the estimated ITN remaining at the end of the day and the reported ITN remaining at the end of the day.
Visualizations¶
The aggregate modules come with a dashboard called “ITN Mass campaign (daily)” that contains the visualization outlined in the table below. If the frequency of data collection is not daily, the name of the dashboard should be adapted.
| Item name | Title | Type |
|---|---|---|
| ITN-MC-001 Outcomes | ITN MC Registration outcomes | Table |
| ITN-MC-002 Outcome indicators | ITN MC Campaign outcome indicators | Table |
| ITN-MC-003 HH reached | Daily campaign progress- households | Bar plot |
| ITN-MC-004 Pop reached | Daily campaign progress- population | Bar plot |
| ITN-MC-005 Report submitted | Number of reports submitted | Bar plot |
| ITN-MC-006 Closing stock | ITN MC Remaining stock at end of each day | Table |