Impact of School-based Delivery of Long Lasting Insecticide Nets

Insecticide-treated nets (ITNs), and more recently long lasting insecticide nets (LLINs), have been shown to effectively protect those groups most biologically vulnerable to the burden of malaria across Africa. However, achieving universal coverage, especially in poor and remote areas, has proved a particular challenge and there remains a need to explore alternative delivery mechanisms. The recent introduction of universal primary education in Kenya has meant that even the poorest households are sending at least one child to school, providing a complementary, potentially equitable, mechanism through which to distribute LLINs. The delivery of LLINs through schools will be piloted by Population Services International in schools situated along the Tana River in North Eastern Kenya. This proposal seeks to evaluate the impact of this programme on both household use of school donated, free LLINs and the health of schoolchildren. The study hypothesis is that the free delivery of long lasting insecticide nets (LLINs) through schools will increase household LLIN coverage among younger siblings not enrolled in school and will reduce rates of malaria infection and anaemia among school children. The study will be an impact evaluation of a programme delivering LLINs through schools, which is to be implemented by Population Services International (PSI)-Kenya. The programme will be implemented in 50 schools and due to PSI-Kenya's roll out, the programme will be phased in over two years. will be phased in over two years. The 50 schools will be randomly divided into two groups, the first 25 schools will receive LLINs in 2009 and the second group will receive them in 2010. In each school, five households will be randomly selected and household surveys will be conducted to collect information on household net use and household demographic and socio-economic status. School health surveys will be completed at the end of the programme to assess programme impact on malaria infection and anaemia.

• Experimental: 1
  Free distribution of long lasting insecticide nets to school children and their younger siblings
  Intervention: Device: School-based delivery of long lasting insecticide nets
• Experimental: 2
  No school-based delivery of long lasting insecticide nets in the first year, followed by free delivery in the second year
  Intervention: Device: School-based delivery of long lasting insecticide nets

Inclusion Criteria:

• Pupil enrolled at participating schools in standards 1-7;
• Provision of informed consent from parent or guardian; AND
• Provision of assent by student.

Exclusion Criteria:

• Non-provision of informed consent; OR
• Pupils unwilling to participate in the study.