School Net Programme

In 2011 the MoHSW initiated a wide scale consultative process to define future continuous or “Keep-Up” distribution system to cover new sleeping spaces and to replace lost or worn out nets after the two mass campaigns. A detailed report is available in the Resource Centre: "Tanzania Keep-Up Strategy Report", July 2011.

It is estimated that approximately 7 million new LLIN need to be distributed annually to maintain universal coverage of over 80%, increasing to 8 million by 2020. A combination approach of TNVS and a school-based net distribution programme was proposed as the most cost-effective and efficient keep-up strategy for Tanzania in the current situation. The strength of the model lays in the combination of the two distribution approaches, with the TNVS providing 30% of the LLIN to pregnant women and children under 5 years, a key target group that cannot be reached through school-distribution.

The School Net programme is a complementary continuous distribution strategy to the TNVS and involves free distribution of LLINs on an annual basis to all school children in selected class. This programme was piloted in the 19 districts of the Southern Zone (Lindi, Mtwara and Ruvuma Regions) in 2013. Over 500,000 LLINs were distributed to all 2,300 primary and secondary schools. USAID is funding a second round of SNP in the Southern Zone late 2014. The MoHSW will decide after the evaluation of the second round whether the SNP will be adopted as the national Keep Up Strategy.

Schools are an effective point to distribute nets to households to ensure that sufficient nets are distributed annually. As providing a LLIN to each student would provide more nets than needed to maintain universal coverage a staggered approach is used, in which students in standards 1, 3, 5, and 7 and Form 2 and 4 receive a net annually. This will provide enough nets annually to sustain 80% coverage. The assumption is that as the child moves through the school systems, s/he will bring home a new net every two years, which will be redistributed within the household.

Identification of school children is relatively straightforward using school registers. Enrolment is the highest for standard one and falls in each subsequent year as students either drop-out of the school-attending population or die.  Standard 1 (ages 6-7 generally) is a good time for the household to get a new net, as the net obtained as an infant or an under-five would be wearing out. Households without pregnant women, infants or school-going children represent ~16% of all households and 5% of the population.

The first round of the SNP was evaluated by IHI (see report "Evaluation of School Net Pilot Project in the Southern Zone (draft)" in the Resource Centre) and a procedural audit was conducted by an audit firm (see report "Procedural Audit Report on the Distribution of LLINs in Southern Zone [...]" in the Resource Centre). The main conclusions were:

  1. Delivery of LLINs to the households through school children is a feasible strategy for scale-up provided administrative and financial management of training, transportation of nets, registration and issuing is fully delegated to Local Government Authorities.
  2. The design of the SNP can be modified to reach those households that currently do not have a pregnant woman, infant or school-going child.
  3. SNP is successful in increasing coverage but it cannot bring coverage back to 80% once it has dropped below a certain threshold (<50 -60%). SNP needs to be implemented relatively soon after the completion of the mass campaign (modeling suggests 9 – 12 months) to ensure coverage does not drop below ‘threshold’.