A Sudanese mother with her baby
holds a voucher which she will
exchange for a free mosquito net.
JUBA, Southern Sudan – On July 31, a coordinated malaria control campaign – led by the Government of Southern Sudan (GoSS), Ministry of Health (MOH) and executed by PSI and partners – delivered its one millionth long-lasting insecticide-treated mosquito net (LLIN) in Southern Sudan.
The free mass LLIN distribution campaign reached more than two million people in Western Bahr El Ghazal and Warrap, two of the region’s most inaccessible and affected states. PSI was contracted by the MOH/GoSS to coordinate the campaign in April 2007. The Multi-Donor Trust Fund (MDTF), administered by the World Bank, provided financial management oversight and support.
With coverage rates in Southern Sudan at less than 10% and only enough LLINs to cover a small proportion of the population, it was critical for PSI to work with the MOH to develop a distribution strategy that emphasized a phased and long-term approach to LLIN delivery. With a rainy season fast approaching that would render many target populations inaccessible, a challenging task lay ahead and the challenges only increased as the planning process progressed and the distribution deadline neared.
Plans moved forward in earnest at the end of 2007 when coordinating partners reached an agreement on target areas and drafted a plan of action. In January 2008, the plan was finalized and officially endorsed, with a goal of rolling out the campaign between April and July 2008. The challenges the GoSS and PSI faced in the roll out included extreme time constraints, inadequate infrastructure, the concurrent implementation of a National Population and Housing census that overstretched already scarce physical and human resource capacity, tribal fighting, a lack of reliable population data, long distances, and scattered, sometimes semi-nomadic populations.
The operational strategy involved pre-positioning of nets in remote and often insecure areas and pre-registration of households and distribution of vouchers to limit double counting. PSI deployed 13,000 volunteers by motorbike, bicycle or by foot across 3,000 distribution sites to ensure that every household received a mosquito net. Ultimately, the campaign goal was achieved through three distribution operations, each lasting no more than three days.
In six months, PSI/Sudan and the MOH planned for and distributed more than one million LLINs in a mass distribution that would normally take more than a year of planning and preparation.
Hassan Alghali Adam, GoSS acting executive director and coordinating committee chair of malaria net distribution, said, “No single village was left out of this campaign. All the local chiefs and government officials participated, thanks to training from PSI staff person Amin Joseph and MOH official Farjalla Emilion.”
The success of the campaign helped Southern Sudan secure further support from the Global Fund, MDTF, USAID and other donors to scale up mosquito net coverage over the next two years to reach the government’s coverage goals (the internationally agreed Abuja Targets) a year early. This effort includes ongoing distribution of 180,000 LLINs in Western Equatoria; achieving 80% coverage in three counties; UNITAID procurement of 1.6 million LLINs; and procurement of three million LLINs under Global Fund round seven.
Lessons learned are being documented to ensure the successful roll out of this initiative across the remaining states of Southern Sudan, possibly with the added aim of combining net delivery with vaccinations and vitamin A provision as part of a more integrated child survival package.
