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Impact of a 15-month multi-channel continuous distribution pilot on ITN ownership and access in Eastern Region, Ghana

Overview of attention for article published in Malaria Journal, March 2018
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Impact of a 15-month multi-channel continuous distribution pilot on ITN ownership and access in Eastern Region, Ghana
Published in
Malaria Journal, March 2018
DOI 10.1186/s12936-018-2275-8
Pubmed ID

Celine Zegers de Beyl, Angela Acosta, April Monroe, Felix Nyanor-Fosu, Joshua Kweku Ofori, Obed Asamoah, Prince Owusu, Sureyya Hornston, Lilia Gerberg, Megan Fotheringham, Albert Kilian, Hannah Koenker


Insecticide-treated nets are a key intervention for malaria prevention. While mass distribution can rapidly scale up ITN coverage, multiple channels may be needed to sustain high levels of ITN access and ownership. In Ghana's Eastern Region, a continuous ITN distribution pilot, started in October 2012, 18-24 months after a mass campaign. The pilot distributed ITNs through antenatal care services (ANC), child welfare clinic services (CWC) through the Expanded Programme on Immunization, and to students in two classes of primary schools. ITN ownership and access were evaluated through two cross-sectional surveys, conducted at baseline in April 2012, 11-15 months after the mass campaign, and at endline in December 2013, after 1 year of continuous distribution. A representative sample was obtained using a multi-stage cluster sampling design. Household heads were interviewed using a structured questionnaire. Household ownership of at least one ITN was 91.3% (95% CI 88.8-93.9) at baseline and was not statistically significant at endline 18 months later at 88.3% (95% CI 84.9-91.0) (p = 0.10). Ownership of at least 1 ITN per two people significantly decreased from 51.3% (95% CI 47.1-55.4) to 40.2% (95% CI 36.4-44.6) (p < 0.01). Population access to an ITN within the household also significantly decreased from 74.5% (95% CI 71.2-77.7) at baseline to 66.4% (95% CI 62.9-69.9) at endline (p < 0.01). The concentration index score for any CD channel was slightly positive (0.10; 95% CI 0.04-0.15). Thirty-one months after the mass campaign, the 15 months of continuous distribution activities had maintained levels of household ownership at least one ITN, but household ownership of one ITN for every two people and population access to ITN had declined. Ownership and access were higher with the CD programme than without. However, the number of ITNs delivered via ANC, CWC and two primary school classes were insufficient to sustain coverage targets. Future programmes should implement continuous distribution strategies fully within 1 year after a campaign or widen eligibility criteria (such as increase the number of classes) during the first year of implementation to make up for programme delays.

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Mendeley readers

The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 61 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 16 26%
Researcher 8 13%
Student > Bachelor 6 10%
Student > Doctoral Student 4 7%
Lecturer > Senior Lecturer 2 3%
Other 7 11%
Unknown 18 30%
Readers by discipline Count As %
Nursing and Health Professions 11 18%
Medicine and Dentistry 11 18%
Agricultural and Biological Sciences 5 8%
Social Sciences 5 8%
Immunology and Microbiology 2 3%
Other 10 16%
Unknown 17 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 March 2018.
All research outputs
of 12,719,839 outputs
Outputs from Malaria Journal
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Outputs of similar age
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Outputs of similar age from Malaria Journal
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Altmetric has tracked 12,719,839 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,732 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.3. This one is in the 35th percentile – i.e., 35% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,573 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them