1
Presentation number 1111 • • ziri Nyoni 1 , David Dadi 1 , Noella Kisoka 1 , Kanuth Dimoso 1 , George Kabulika 1 , Dismas Mwalimu 2 , Renata Mandike 2 , Ally Mohamed 2 , George Greer 3 , Naomi Kaspar 3 , Eric Shoo 5 , lkupa Akim 4 , Ato Selby 1 , Eric Filemyr 1 , Hannah Koenker 1 , Matt Lynch 1 1 VectorWorks Project, Johns Hopkins Center for Communication Programs, Baltimore, MD, United States, 2 National Malaria Control Program, Dar es Salaam, nzania, 3 President's Malaria Initiative, Dar es Salaam, nzania, 4 Swiss Tropical and Public Health Institute, Dar es Salaam, Tanzania, 5 VectorWorks Project, Population Services International, Dar es Salaam, Tanzania INTRODUCTION In 2011, the Ministry of Health and National Malaria Control Program (NMCP) of Tanzania developed a Keep Up Strategy with the goal of maintaining the population's access to an insecticide-treated net (ITN) at or above 80% by using school-based distribution as an innovative distribution channel. During the last five years, improved coordination between government offices has streamlined operations, and preliminary analysis points toward significant cost savings for implementation. School net distribution (SNP) was first piloted in the Southern Zone in 2013. The NMCP and the Tanzanian Red Cross Society distributed 421,285 ITNs to classes 1, 3, 5, and 7 in primary school and Forms 2 and 4 in secondary schools to 2,302 schools in 19 districts in Lindi, Mtwara, and Ruvuma. NMCP and Research Triangle Institute implemented SNP2 in 2014 delivering 489,099 ITNs to school children, and adding classes 2 and 4 in Lindi. In the third round in 2015, NMCP, with the VectorWorks project, delivered 494,407 ITNs to 1,919 schools in the 19 districts. They targeted classes 1-3, 5, and 7 in primary schools in Ruvuma and Mtwara, and classes 1-5 and 7 in Lindi. In 2016, SNP4 expanded to four additional regions in the northern Lake Zone; 1,152,715 ITNs were delivered to 5,242 schools for a total of seven regions. SNP5 in 2017 will expand to 14 regions. The President's Office of Regional Administration and Local Government (PO-RALG) now coordinates the majority of activities at the regional level and below. SNP IMPLEMENION PROCESS SNP distribution processes have evolved over time. Implementation experiences from one round have informed the next round. Currently, a more thorough cost analysis of SNP is being conducted but anecdotal evidence based on improvements that have been done in implementation process show that there are greater efficiency gains. Primary school students in Ruvuma showing their ITNs. 1. rgeted training approach SNP has cut training costs by reducing the number of trainees. SNPl & SNP2 training included 2 teachers from each school and 1 ward education coordinator (WEC) from each ward. This was costly: for example, SNP2 trained 3,838 teachers and 448 WECs. Beginning with SNP3, VectorWorks simplified SNP operations, which resulted in eliminating the need for training school teachers and WECs. This approach represents a savings of $280,786.67 across the 14 regions in SNP5. 2. Centralized quantification of pupils data During SNP 1-3, ward education officers were trained to collect pupils' data and issue reports. Instead of collecting this data for SNP4 & SNP5, VectorWorks used centralized data collected by the PO-RALG under the Basic Education Management information System (BEMIS). After receiving the data, VectorWorks conducted desk validation by using the previous year's data, which proved to be over 95% accurate. This saved time and money compared to collecting the data solely for the purpose of SNP quantification. 3. LLINs re-bundling on the go to avoid storage cost and time During SNP 1-3, ITNs were delivered to districts based on quantification data. ITNs were then stored at the district warehouse for 7-10 days to allow re-bundling in stacks equivalent to quantified school needs. In SNP4 & SNP5, ITNs were delivered to districts in 40-foot trucks, which were offloaded to smaller trucks and were ready for delivery to schools. Rebundling (breaking of bales) happened only as ITNs were off-loaded at schools. This saved time and substantially reduced distribution costs. 4. Automated pre- and post-delivery notifications Automated notifications are sent by the logistics firm to ward education coordinators, who supervise two to six schools in each ward. The notifications include when ITNs will arrive, how many ITNs each school will receive, and a reminder that a reipresentative will bring ITNs on a set date. This poster is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the President's Malaria Initiative (PMI) under the terms of USAID/JHU Cooperative Agreement No AID-OAA-A-14-00057. The contents do not necessarily reflect the views of PMI or the United States Government. Contact: Waziri Nyoni, [email protected] 5. Using technology to improve accountability Previous rounds of SNP used paper invoices to account for ITNs. It took about 7 days for all the paperwork to travel to the central office before they could be reconciled. In SNP4 & SNP5, VectorWorks used a mobile phone and web-based system to ensure that deliveries were made to the right locations, in the right quantities. This made the entire process faster and increased accountability, because any discrepancies can be traced to exactly where and when they occurred in the the supply chain. 6. Integrated reporting through PO-RALG open data website -BEMIS dashboard In the previous rounds of SNP, the implementing project reported on ITNs distributed. From SNP4 on, reporting was done by and through the PO-RALG integrated open data dashboard, which is publicly available. On the website, student registration data, ITN delivery manifest, and issuing data are displayed together. This has reduced cost and time in processing issuing reports, and it has increased accountability on the data, as well as data accuracy. - THE UNITED REPUBLIC OF TANNIA - Presidents' i� - Regi onal Administration and Local Government Baste Education Statistics Log in Net delivered to schools based on pupil s registered by sex in Tanzania 5 [N?da1ivd10";'0h;olsb0nppils"isterx I Simiyu Arusha Kilimanjaro Kigoma Manyara Tanga Tabora Singida Dodoma Ka!a�i ani Tanzania Co v Print Region MALE Geila 74222 Kagera B878 Lindi 611D 100k MM, @4! I Mtwara 106<7 Mwza 200k R571 RwLJma 121105 h: FEMALE Total 725 146722 64854 133732 61310 122478 61255 125686 1091 215787 81628 164199 1230( 244111 Rukwa lringa Morogoro I lOOk TI 578982 5737 1152715 Songwe Mbeya Swing 1 to 7 of 7 entries Previous + D N•tur�I Urth CONCLUSION During the last five years, SNP implementation has improved significantly to increase local government ownership, efficiency, and accountability. In the current and future rounds of SNP, enrollment data collection has been streamlined and digitized, training requirements have been reduced, and transport and storage have been optimized in collaboration with the private-sector logistics partner. Final data on cost savings is being analyzed and will be shared in the future. t:·,�, USAI D 1· 1 ' -. . \,I i � - & ' '·-�iiif)§'• ' FROM THE AMERICAN PEOPLE �,, °'"""' co• o,s«ss· conooc ••• ""'°"""°' U.S. President's Malaria Initiative VECTOR WOR Scaling Up Vector Control for Malaria Prevention • psi Healthy lives. Measurable resutts. SwissTPH 9 Swiss Tropical ad Public Health Institute Schweizerisches Tropen- urod Public Health-lnstitut I nti1ut Tropic;d et de Sante Publique Suisse JOHNS HOPKINS Center for Communication Programs ™ -- w.,. N
