Digitalisation of mosquito net distribution shows key benefits for campaign monitoring

Digitalising insecticide-treated net distribution to improve the accuracy of data collection and allow real-time data use is yielding promising results in South Sudan and Nigeria, according to new research.

Distributor of insecticide-treated nets looks at digital tool on mobile device, Aweil West, South Sudan

The distribution of insecticide-treated nets (ITNs) forms the mainstay of malaria prevention. The World Health Organization recommends that net distribution campaigns are held at regular intervals alongside continuous distribution channels such as antenatal care and immunisation clinics. Teams distribute the nets and collect distribution data using paper-based or electronic systems. Although paper forms are simple for distributors to use, omissions and inaccuracies can occur during data collection and collation, and data reporting is slow. This hinders stock management and distribution workflow, and makes it difficult for supervisors to make timely decisions to course-correct and accurately monitor the overall progress of the campaign.

In partnership with South Sudan’s National Ministry of Health, Malaria Consortium developed a digital data collection application to support ITN distribution. The digital tool has been designed with offline functionality, so data can be collected in areas with poor network coverage and is interoperable with the Digital Health Information System (DHIS2) to allow real-time decision making.

Dr Jamshed Khan, lead author of a Malaria Journal paper on the acceptability of the digital tool to users, says: “Digitisation is possible in a resource-limited area like South Sudan with challenges of low internet coverage and lack of digitally-skilled volunteers.”

To assess the usability of the tool, the research team randomly assigned a questionnaire to 93 participants, including distributors, supervisors and other key stakeholders. Most respondents said they would recommend the tool to colleagues, and thought the tool was easy to use, reduced their workload and was useful for managing ITN distribution, stock management and real-time campaign monitoring. Respondents who had used both the digital tool and paper-based system data collection preferred the digital tool. Further research is needed to explore the effectiveness of the tool and its ability to improve data quality and optimise decision-making.

In Ondo state, Nigeria, digitalisation was first introduced to elements of a net distribution campaign in 2017 and expanded in 2021 to overcome some of the challenges posed by the COVID-19 pandemic and improve the efficiency and accountability of the distribution process. A recent paper published in Malaria Journal highlights the benefits of digitalisation on monitoring the quality of implementation and tracking assets and staff, as well as the importance of training teams to ensure that digital tools are used optimally. Mobilisation and distribution teams used the digital application to monitor campaign planning and delivery, collect household information and track net transfer between distribution hubs and households.

According to Dr Tarekegn Abeku, Principal Advisor at Malaria Consortium, “The digital system allowed real-time monitoring of the campaign’s progress through capture of household level data that was used to map and visualise the daily coverage. Information such as geolocations and number of nets issued to each household versus number of residents could be used beyond the campaign in studies that make use of the data by linking with other operational or epidemiological parameters.”

Digitalisation of health systems and workflows has tremendous potential to address health system challenges in low- and middle-income countries. It provides opportunities to connect patients and health workers, support service delivery, capture health information from remote settings, ensure data quality and reduce lags in data flow.

Read about some of Malaria Consortium's other digital projects here:

Introducing a digital intervention to strengthen the Boma Health Initiative

Cross-border project – RAI4E