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Under-five Catch Up Campaign


Between 2004 and 2008, household ownership and coverage of vulnerable groups grew steadily from year to year as a result of the combined effects of the social marketing of Insecticides Treated Nets (ITNs) and the voucher programme (TNVS). Despite this steady growth, it became clear in 2007 that when coverage was disaggregated by socio-economic groups, the ITN coverage in the poorest groups made very little progress. The progress for coverage of children under-five and pregnant women was too slow to achieve the Ministry of Health and Social Welfare (MoHSW) target of 80 percent ITN coverage by 2013.


The rising top-up amount to redeem a voucher for an ITN was recognized as one of the major constraints. The price of a subsidized ITN became unaffordable for many recipients in rural areas. Despite the success of the SMARTNET programme and increasing net re-treatment rates, the coverage remained below 30 percent by 2007.

Submission of proposal to up-scale ITNs

To rapidly and equitably increase ITN coverage, the MoHSW submitted a proposal to the Global Fund to fight AIDS TB and Malaria to co-fund (together with the World Bank and PMI) a national “catch up” campaign to distribute Long Lasting Insecticides Nets (LLINs) to children under-five years.  Projections from the National Bureau of Statistics indicated that 7.2 million Long Lasting Insecticides Treated Nets (LLINs) would be needed for mainland Tanzania. In October 2008, the MoHSW through the National Malaria Control Programme (NMCP) started to implement the Under-five Catch Up Campaign (U5CC).


The U5CC was jointly funded by the Global Fund to fight AIDS TB and Malaria (GFATM), the World Bank (WB), the President’s Malaria Initiative (PMI), the Swiss Agency for Development Cooperation (SDC), the Department for International Development (DfID), the Ministry of Health and Social Welfare, Malaria No More, World Vision Switzerland, and the Davos World Economic Forum. The budget for the implementation of the U5CC was $69 million.

The U5CC was coordinated by the MoHSW through the ITN Cell of the NMCP and implemented by a number of contracting partners together with local government officials who are under the Prime Minister’s Office– Regional and Local Government (PMO-RALG).

Initially, it was anticipated that the whole campaign would require the purchase of 5.7 million LLINs. At the completion of the exercise in May in 2009, a total of 9 million LLINs had been distributed to all children on the Tanzanian Mainland. This campaign introduced for the first time in Tanzania LLINs which can last up to five years without being retreated. This provides a much longer protection hence enabling the families to strengthen their economy.

Under-five Catch Up Campaign Contractors

The U5CC contractors were the Mennonite Economic Development Associates (MEDA), World Vision Tanzania (WVT), Population Services International (PSI), A-Z Textile, and Ifakara Health Institute (IHI). Each of the contractors had a specific duty in the implementation of the national campaign (see section on Implementing Partners).

The Implementation Process

Women and their under-five pose after the distribution of the U5 Campaign


The U5CC proceeded on a zone by zone basis, with LLIN issuing scheduled in a different zone each month. Mainland Tanzania has eight zones, each of which contain two or three regions. Each region contains between four to five districts. Upon arriving in the regions, all contractors attended a coordination meeting chaired by a MoHSW representative.  Contractors shared the U5CC work plan and obtained information on the number of  underfives, and participation of local government officials in each district in that region.

Following the meeting, contractors and the MoHSW presented themselves to regional and district officials for a courtesy call. The courtesy call provided an opportunity to address district specific issues and obtain any additional information required. The Council Health Management Teams (CHMT) were among the attendees to these meetings.  As the CHMTs conduct district level supervision and administration of payments to village and ward level officials and volunteers, their full understanding of the U5CC was critical to the success of the campaign in each district.