Using RapidPro to support the distribution of long-lasting insecticide-treated bed nets

Launched: May 2017

During the May 2017 integrated health campaign known as the ‘Mami en pikin welbodi week’, which aims to prevent illness and deaths among children under the age of five, the Ministry of Health and Sanitation (MoHS) aimed to distribute 4.3 million long-lasting insecticide-treated bed nets (LLINs) to all households in the country.

Given the huge logistics undertaking required, the importance of success and the previous use of RapidPro in supporting free health care (FHC) distributions, the National Malaria Control Program (NMCP) campaign team opted to include RapidPro as a support to the LLIN distribution, focused on the Western Area.

The RapidPro support to the LLIN campaign in the WA was split into two phases:

  1. Preparedness: Checking if PHUs have received the pre-determined quantity of LLINs and household (HH) vouchers. Identifying any non-delivery or discrepancies between the quantity of stocks to be received versus the quantity of stocks actually received.
  2. Distribution: Tracking the daily distribution rate of LLINs and policy compliance status for all peripheral health units (PHUs). Any non-compliance (receipt of vouchers not equal to distribution of nets) should be highlighted.

For each phase, the data submitted by the PHUs daily were collected and evaluated by the NMCP Command Center team before a district-specific report was shared with district medical officers (DMOs), district malaria focal points and national supervisors. District health management teams (DHMTs) were then to coming up with and implement any required correction actions.

Over the 12 days of the distribution phase, the PHUs reported at an average rate of 57% and a high of 72%, on day 4. The reports showed a much higher rate of non-compliance during the first four days of the distribution, which decreased thereafter, possibly as a result of corrective actions taken by the NMCP team. The non-compliance rate from reporting PHUs decreased from 54% on the first day of the distribution, to 8% on the last.

Adding the real-time reports to the original stock distribution balance, we were able to identify 39 facilities with potential stockouts by the midpoint of the distribution, in advance of it occurring.

Lessons learnt:

  • Response rates from PHUs were lower than hoped for, even though all facilities had taken part in training and sensitization – further endorsement and/or underlining of RapidPro as being a MoHS official tool may be required to drive acceptance.
  • RapidPro was brought on-board relatively late in the planning of the LLIN distribution. It would have been more effective to have had in place earlier.
  • The make-up of the district level response team should be reviewed for any similar future distributions – the group selected for this were too overloaded with other tasks to engage fully with corrective actions. Most burden fell on one person at the NMCP control centre. 

For more information please contact Shane O'Connor- Technology for Development Specialist, UNICEF Sierra Leone