Background: Nigeria, in its quest to scale up coverage and
utilization of LLINs as a strategy for malaria control, had the first long lasting
insecticidal net (LLIN) mass campaign across the country between 2009-2013. The NMEP with
support from its RBM partners successfully distributed over 57.7 million LLINs
during the period representing over 90% of the national target. In spite this,
and to achieve universal coverage, the country maintained a continuous
distribution through multiple channels and in particular the antenatal care
outlets and the expanded programme on immunization. The Nigerian government,
with support from the Global Fund and through the National Malaria Elimination
Programme (NMEP), Catholic Relief Services (CRS), and the Society for Family
Health (SFH) and with technical support from the World Health Organization,
once again launched the LLIN replacement campaign in some states across the
country. Methods: A cross-sectional survey was conducted in five states that
conducted the LLIN replacement campaign using the lots quality assurance survey
(LQAS) tool developed by the World Health Organization. The period of the
survey across the states is between August and December 2017. The LQAS questionnaires
were administered to households (HHs) by the WHO field officers trained on the
use of the tool at least one week after the campaign. A total of 240 HHs were
selected from 24 settlements (clusters) in 24 wards of six LGAs (lots) from
each of the five (5) states that rolled out the campaign. Data collected were
double entered, cleaned, crosschecked, and the results analysed using the SPSS
version 24. Results: With a total of 9740
people surveyed from 1200 HHs across the five states, the average redemption
rate was 95.5% (95% CI, 91.6%
- 98.8%), average retention rate was 98.4% (95% CI,
97.0% - 99.8%),
rate was 82.6% (95% CI, 80.0%
- 85.5%), and an average card ownership of 83.5% (95%
CI, 78.6% - 88.2%).
While the main source
of information 35.4% (95% CI, 21.8%
- 49.0%) about the LLIN campaign was the health workers, the reasons for those
missed out were mainly due to team performance 32.2% (95% CI, 26.8% - 37.4%) and net cards not
issued 27.4% (95% CI, 23.2% - 32.0%).
Similarly, the Pearson correlation (0.942, α 0.017, p < 0.05, 2-tailed test),
the ANOVA test (F value of 23.751, α 0.017, p < 0.05), and Regression
analysis (R-square 0.888 and Durbin-Watson 2.487), all shows significant
relationships between LLIN redemption and usage with a resultant rejection of
the Null Hypothesis. Conclusion:
The outcome of this research underscores the need to adopt and scale up the use
of the LQAS tool to assess the quality of LLIN campaigns within the shortest
possible time. While the LQAS has been in use by the WHO Expanded Programme on Immunization
cluster during polio campaigns, this is the first time that the tool was
deployed by the WHO malaria unit as a strategy to identify post LLIN campaign
gaps immediately after implementation. The
scaling up of this strategy would
undoubtedly improve LLIN campaigns that would be conducted in the remaining states across the
country so as to ensure that
Nigeria achieve LLIN universal access in line with the
Global Technical Strategy (GTS) framework toward malaria elimination.
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