Request For Information - Malaria Vector Control Activity.pdf

REQUEST FOR INFORMATION (RFI)

RFI Number: RFI-621-24-HO-00001 Issuance Date: October 17, 2023 Response Due Date and Time: October 27, 2023, 5:00 PM Tanzania Time Response Email Address: usaidtzco@usaid.gov copy emeena@usaid.gov

ANTICIPATED PROJECT TITLE: USAID Malaria Vector Control Activity (MVCA)

Dear Interested Parties:

The United States Agency for International Development (USAID) Mission in Dar es Salaam, Tanzania is publishing this Request for Information (RFI) to obtain information and inputs from all capable and interested entities for the anticipated USAID Malaria Vector Control Activity designed to identify and implement proven, evidence-based vector control approaches in Tanzania, in support of reducing the overall malaria burden, and moving Tanzania closer to malaria elimination.

This RFI is issued to collect expert industry inputs, solely for information-gathering purposes. Issuance of this RFI does not constitute a Request for Applications (RFA) or Request for Proposals (RFP). Responses to this RFI are not an application or official proposal and will in no way be deemed to form any binding agreement with USAID/Tanzania. The RFI does not represent an award commitment on the part of USAID/Tanzania, nor does it obligate USAID/Tanzania to pay for costs incurred in the preparation and submission of any comments. Responders are solely responsible for bearing all expenses associated with preparation and submission of the response to this RFI. USAID reserves the right to, or not to incorporate any, some, or none of the Information received in response to this RFI into any subsequent solicitations or design documents, therefore, proprietary information should not be sent.

Anticipated Term: TBD Proposed Mechanism Type: TBD

It is the potential responder’s responsibility to monitor the site for the release of any further information. It should be noted that responding to this RFI will not give any advantage to any Organization in any subsequent procurement. Any information submitted in response to this notice is voluntary.

The response requirements and draft scope is provided with this RFI and are attached below.

Responses to this RFI should be sent to usaidtzco@usaid.gov copy emeena@usaid.gov no later than the date and time shown above. Please include “USAID Malaria Vector Control Activity” in the Subject Line.

Responders will not receive individualized feedback. Specific questions about this RFI should be directed only to the email addresses indicated above. No basis of claims against the USAID/Tanzania shall arise as a result of a response to this request for information or from USAID/Tanzania use of such information.

We look forward to receiving your comments.

Best Regards, Brian K. Woody Contracting/Agreement Officer USAID/Tanzania

BRIAN K WOODY

Digitally signed by BRIAN K

WOODY

Date: 2023.10.17 08:46:41 +03'00'

Attachment 1

RFI and submission Instructions:

Through this RFI, USAID/Tanzania seeks ideas, comments, and information on the best approaches that will assist in developing an activity to effectively advance the topic areas described below.

Response Requirements Responses to this RFI must include the following:

1. Include a table that contains the following information:

A. Organization name and address B. Organization points of contact (POCs), telephone number and email address.

C. A brief statement indicating the organization’s interest in proposing as a prime or sub.

D. Is the organization registered to work in Tanzania?

E. Does the organization have extensive experience distributing insecticide-treated mosquito nets?

2. Please provide feedback on the following questions:

a. Are the proposed objectives for the anticipated USAID Malaria Vector Control Activity (MVCA) as described in the draft scope, section A, sufficient to yield the desired results as articulated, is anything missing or not essential?

b. USAID/Tanzania is interested in learning of efficient and cost-effective ways to distribute insecticide-treated mosquito nets (ITNs) throughout the Mainland and Zanzibar. Please describe your organization's experience in distributing the same or similar products throughout Tanzania. In reviewing the draft scope, are there areas where USAID could enhance the narrative to ensure an efficient and cost-effective approach to distribution?

c. How might interventions in the draft scope be effectively coordinated?

d. Are the proposed objectives achievable under one activity/implementing mechanism or would it be more prudent to separate the objectives into several activities/implementing mechanisms? Is there a specific implementing mechanism(s) that would yield the best results?

e. Do you have any general feedback or recommendations on Attachment 2- Draft Scope?

f. How could USAID/Tanzania leverage the Private Sector through this project?

g. Are there any environmental concerns or opportunities for climate adaptation or mitigation of this Activity?

h. What changes would you propose to Attachment 2 to encourage participation of Tanzanian partners in this proposed activity?

3. Are there any cost-related obstacles you can foresee related to this activity?

4. Please include any other comments or inputs you may have on the draft scope.

Attachment 2

SECTION A: DRAFT - SCOPE

Anticipated Title: USAID Malaria Vector Control Activity

Purpose

The purpose of the activity is to identify and implement proven, evidence-based vector control approaches in Tanzania, in support of reducing the overall malaria burden, and moving Tanzania closer to malaria elimination. This activity does not include implementation of indoor residual spraying (IRS) or larval source management. The activity has three primary components: (1) Insecticide-treated mosquito net (ITN) distribution, (2) Social and behavior change (SBC) for ITN use and other vector control interventions, and (3) Entomology Monitoring, and use of data to provide quality technical expertise to the Government of Tanzania and malaria partners on technical guidance concerning new developments in vector control, and as appropriate, develop plans for implementation of modified or new vector control approaches in Tanzania.

Background

The U.S. President’s Malaria Initiative (PMI) is led by the U.S. Agency for International Development (USAID) and implemented together with the U.S. Centers for Disease Control and Prevention (CDC). Launched in 2005, the PMI supports implementation of malaria prevention and treatment measures as well as cross-cutting interventions. PMI’s 2021-2026 strategy, End Malaria Faster, envisions a world free of malaria within our generation with the goal of preventing malaria cases, reducing malaria deaths and illness, and eliminating malaria in PMI partner countries.

Guided by the PMI strategy 2021- 2026, PMI aims to save lives, reduce health inequities, and improve disease surveillance and global health security.

Since 2000, the scale up of interventions for malaria control including vector control and improved case management has led to dramatic reductions in the malaria burden in Africa with prevalence declining by 50% and the incidence of clinical disease by 40%. Much of the decline has been attributed to the scale up of vector control, with insecticide treated nets (ITNs) and indoor residual spraying (IRS) estimated to account for 68% and 13%, respectively, of the cases averted.

Making ITNs available to the community is a necessary but insufficient condition for reducing malaria transmission; correct and consistent use of proven interventions, including ITNs is also needed. Social and behavior change (SBC) activities play a critical role in promoting uptake of vector control interventions.

The provision and promotion of ITNs should be done in the context of a larger integrated vector management (IVM) strategy. The backbone of this strategy is entomological monitoring:

understanding and monitoring the local mosquito population, their behavior, and their insecticide resistance status are critical to continued success. With the changing malaria situation and changing ecology and biology of mosquitoes – as well as new chemicals and formulations becoming available for mosquito control in the next few years – it is essential to monitor, adapt, and respond to changes in mosquito populations. Entomological data should be used to guide the selection, deployment, and monitoring of vector control interventions and should be based on insecticide resistance and vector bionomics data as well as other factors including community acceptance, cost, and national strategy/policies.

Finally, emerging trends pose threats to gains made in malaria control. Insecticide resistance is one such threat; one of the primary vectors in the mainland, Anopheles (An.) gambiae, is resistant to pyrethroids. While other insecticide classes are currently effective, there is concern that this is reducing. Also, Tanzania is at high risk for the introduction and establishment of An. stephensi, an invasive malaria mosquito in Africa with a unique ecology allowing it to thrive in urban habitats as well as rural habitats, persist throughout dry seasons, and has shown resistance to insecticides.

This vector may halt, or even reverse progress made on malaria control and elimination. In 2023, this invasive mosquito was detected in Ethiopia, Ghana, Nigeria and Kenya. Enhanced vector and disease surveillance, coordinated intervention implementation, and close monitoring are necessary to mitigate the likely harmful effects. New vector control technologies are being developed, but not yet widely deployed, and should be explored given the dynamic nature of malaria transmission.

Malaria in Tanzania Malaria in Mainland

The entire population of Mainland Tanzania is considered at risk for malaria, although transmission varies among and within regions. Malaria prevalence of the country is estimated to be 8 percent (Tanzania Demographic and Health Survey-Malaria Indicators Survey [TDHS-MIS], 2022). Prevalence of malaria in rural areas is 10 percent, while in urban areas it is reported to be less than 1 percent. Overall malaria prevalence in children ranges from <1 percent percent in Arusha, Kilimanjaro, Manyara, Dodoma, Singida and Songwe, to 20 percent in Mtwara and 23 percent in Tabora (TDHS-MIS, 2022).

The peak period of malaria transmission in the country varies. The north and east experience two rainy seasons in October to December and March to May, while the central, southern, and western regions have one longer wet season from October through April or May. Rainy seasons correspond to high malaria transmission periods. Around the Lake Zone of mainland Tanzania, An. funestus s.s is the most abundant vector and An. arabiensis is the second most abundant vector, followed by An. gambiae s.s and An. parensis. (National Institute for Medical Research [NIMR], 2021).

Tanzania continues to fight malaria and has made progress over the years.

According to (TDHS-MIS, 2022), 74 percent of households own at least one ITN, an increase from 38 percent as reported in 2007–2008. This percentage is comparable but slightly lower than the 78 percent estimate of ITN ownership during the year 2015–16 (TDHS-MIS). Additionally, 66 percent of pregnant women slept under an ITN the night before the survey (TDHS-MIS, 2022).

Malaria is dynamic in Tanzania, as shown in the figures below, which show the burden of malaria, by region, in 2018, 2020, and 2023. Where vector control interventions are implemented, and which ones, may shift over time, and should be deployed where they will impact transmission.

In Mainland Tanzania, NMCP’s National Malaria Strategic Plan (NMSP) 2021– 2025 outlines a long-term vision of a society free from malaria. The strategy’s mission is that all Tanzanians have equitable access to sustainable, quality, effective, safe, and affordable malaria preventive and curative services through efficient collaborative partnership and community ownership. The national goal is to reduce the average malaria prevalence in children under five years of age (Plasmodium falciparum parasite rate [PfPR6-59]) from 7 percent in 2017 to less than 3.5 percent in 2025. Further, each of the epidemiological strata has targets which were identified in a nationwide stratification exercise conducted in 2017.

These targets are: 1). reduce malaria burden in moderate to high-risk strata, from 15 percent PfPR in 2017 to less than 7.5 percent PfPR in 2025; and 2). maintain and further reduce transmission in low and very low prevalence in areas targeting elimination from 1 percent PfPR in 2017 to less than 0.5 percent PfPR in 2025.

The strategy to achieve these targets consists of six components. The first three are core strategies, and the last three are support strategies:

● Integrated malaria vector control

● Malaria diagnosis, treatment, and preventive therapies

● Surveillance monitoring and evaluation

● Commodities and logistics management

● Social and behavior change and advocacy

● Program management

Each strategic component has specific objectives and outcomes, with intervention packages that vary by epidemiologic stratum.

Malaria in Zanzibar

The malaria burden in Zanzibar has remained low over the past several years, with a test positivity rate in those seeking care of 1.0 percent in 2021. The Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022 (TDHS-MIS, 2022) showed a malaria prevalence in Zanzibar of 0 percent. There was a 10 percent increase in the proportion of children under age five who slept under an ITN the previous night, from 56 percent in 2016 to 66 percent in 2022.

The TDHS-MIS 2022 also showed that no children under age five had parasitemia by mRDT, a decrease from 0.2 percent in 2017. The percentage of pregnant women who slept under an ITN the previous night increased by 14 percent to 66 percent between 2017 and 2022.

ZAMEP’s approach to malaria is described in the 2018–2023 Strategic Plan IV and the implementation of the new strategy under development (NSP 2024-2028) with a vision of “A healthy population free from malaria in Zanzibar”, a goal to “Accelerate elimination of local malaria transmission and preventing re-introduction”, and a mission to “Provide universal access to quality malaria elimination interventions through evidence-based strategies and multi-sectoral engagement”. ZAMEP’s vision will follow these guiding principles:

● Accountability for results

● Country ownership and leadership

● Partnership and multisectoral engagement

● Community-centered response

● Equity in access to quality malaria services

● Sustainability

● Evidence-based and adaptive management approach.

The Zanzibar Malaria Strategic Plan IV 2018/2019–2022/2023 includes integrated malaria vector control (IMVC) as one of four major strategies for malaria elimination with a corresponding objective to increase appropriate vector control measures to the population at risk for malaria to 100 percent by 2023.

IMVC interventions include reactive IRS in identified areas, or in areas where entomological investigations indicate the need for an IRS intervention;

maximization of ITN ownership and use; larval source management; and vector surveillance in hotspot areas.

President’s Malaria Initiative (PMI) in Tanzania

Tanzania began implementation as a PMI partner country in fiscal year (FY) 2006. The Malaria Operational Plan (MOP) presents a detailed implementation plan for Tanzania based on the strategies of PMI and the National Malaria Control Program (NMCP) and the Zanzibar Malaria Elimination Program (ZAMEP). PMI supports a comprehensive package of malaria control interventions in both mainland and Zanzibar, based on their respective malaria strategies.

Since FY 2006 PMI has continuously supported Tanzania (both Mainland and Zanzibar) on the following interventions: Entomologic monitoring and insecticide resistance management; Insecticide-treated nets; Indoor residual spraying; Malaria in pregnancy;

Case management; Health systems strengthening and capacity building; Social and behavior change communication; Surveillance, monitoring and evaluation; and Operational research.

PMI’s approach in Tanzania reflects all five PMI strategic focus areas, most notably in reaching the unreached with effective vector control interventions by prioritizing distribution of PBO or dual AI ITNs through all the distribution channels, including the School Net Program (SNP), targeted mass replacement campaigns, and health facility antenatal care (ANC) and Expanded Program on Immunization (EPI) clinics; and improving local expertise for entomological, insecticide, and drug resistance surveillance through local and government institutions.

Tanzania, with assistance from Global Fund and PMI is providing ITNs free of charge through different channels including:

● Through all public health facilities nationwide to pregnant women at the first antenatal care clinic visit and to infants at the first measles vaccination

● Through targeted mass campaigns

● In Mainland Tanzania, ITNs are delivered annually to primary school children in selected grades in public schools in identified regions.

● In Zanzibar, through a community-based delivery component.

The goal of delivery through these channels on an annual basis is to maintain population access at greater than 70%.

Mainland In mainland, PMI’s investment strategy focuses on promoting high coverage of a set of high-quality, evidence-based malaria control interventions, including:

● Piperonyl butoxide (PBO) and dual active ingredient (AI) ITNs distributed continuously through clinics and schools, as well as through targeted mass replacement campaigns where necessary based on coverage data.

● Malaria in Pregnancy (MiP) interventions, including IPTp.

● Case management of malaria, including prompt diagnosis and treatment and pharmaceutical supply chain strengthening.

● Data for decision-making, gleaned from SM&E, and operational research

(OR) activities; and

● SBC activities to promote consistent and correct use of malaria prevention, diagnosis, and treatment tools.

In the Mainland, insecticide resistance monitoring takes place across 22 sentinel sites.

Data collected at sentinel sites include phenotypic assays of insecticide resistance and molecular characterization of mechanisms of resistance. Samples are collected from larval collections and analyzed for species identification In Zanzibar, monitoring occurs in sentinel sites and in areas of persistent malaria transmission, providing data on vector species and density, human blood feeding index, and malaria infection rates.

ZAMEP conducts on-site entomological laboratory assays for molecular mosquito species identification, detection of target site mutations of insecticide resistance mechanisms (kdr), and malaria infectivity rates in mosquitoes.

Zanzibar

PMI currently supports nearly all aspects of the ZAMEP strategic plan across all geographic areas of both islands, Unguja and Pemba, with the exception of implementation of reactive IRS. A key component of this support is the distribution of ITNs.

PMI supports entomological monitoring in 10 sites for monitoring of insecticide resistance and vector bionomics. In addition, PMI currently supports one site for enhanced surveillance for An. stephensi in Unguja and plans to start enhanced surveillance for An. stephensi in one site in Pemba . All mosquito samples collected from all sentinel sites will be morphologically examined for An. stephensi and any suspect specimens will be analyzed by molecular methods. PMI supports the procurement and distribution of ITNs via targeted replacement campaigns and continuous distribution of ITNs via ANC and EPI and community distribution channels.

PMI does not currently support actual implementation of LSM activities. However, PMI will provide technical support to improve targeting, monitoring, and evaluation of

LSM.

Relationship to Country Development Cooperation Strategy (CDCS) and other programs Relationship to CDCS

This activity is critical to the achievement of USAID/Tanzania’s Country Development Cooperation Strategy (CDCS) for 2020 - 2025. The CDCS can be found at:

https://www.usaid.gov/tanzania/country-development-cooperation-strategy

The CDCS focuses on three development objectives (DO), including:

(1) improve the foundational skills of children below age 15;

(2) increase the empowerment, productivity, and engagement of Tanzanians from 15 to 35; and

(3) strengthen the capacity of state and non-state actors to benefit future generations.

● DO1 will improve basic education, health care, and nutrition, and provide the safe and supportive environments necessary for Tanzania’s youngest generation to develop into successful adolescents and adults.

● DO2 will build on and reinforce the strengths of young Tanzanians, providing them with the health and education services, pathways to economic opportunity, and civic and leadership skills they need to further self-reliance for themselves, their communities, and Tanzania.

● DO3, will work with local governments to improve enabling environments, citizen-responsive governance, and institutional capacity to provide and manage critical social services such as healthcare and education. The private sector, and the market-based development solutions they develop and champion, are core to the achievement of this CDCS. We will jointly find innovative and sustainable solutions to Tanzania’s development challenges. Similarly, USAID will link with local governments to strengthen their public financial management and build upon their commitment to their constituents.

The MVCA activity will empower Tanzanian women and youth through improved health status as a result of national level reductions in malaria. The MVCA award will improve access to ITNs, particularly for children under 5, and pregnant women, who are more vulnerable to malaria transmission. Additionally, the school-based distribution of nets directly targets protecting children from malaria, thus contributing to DO1.

This activity also supports DO2: “Empowerment, productivity and engagement of Tanzanians aged 15 to 35 increased”. By providing ITNs through targeted mass replacement campaigns, MVCA will work to ensure ITN coverage rates are equitably maintained at desired levels to reduce malaria transmission. Finally, the activity supports DO3. Districts and regions play a pivotal role in both the school-based distribution and the mass replacement campaign, as the planning and execution of these activities require engagement with and leadership from the sub-national levels. These are the same entities that receive Global Fund-procured ITNs and can apply the capacities built through MVCA to ensure efficient and effective distribution of ITNs through these other mechanisms. The activity will also explore opportunities for private sector engagement.

Previous and related awards

MCVA is designed to reflect advances in thinking and lessons learned from past technical assistance (TA) programs. This award builds on USAID | Tanzania’s long history of TA programs to improve malaria related morbidity and mortality and complements other USAID mechanisms working in these areas. Previous and related awards include:

● Tanzania Vector Control Activity was awarded in 2020 to Johns Hopkins Center for Communications Programs

● Dhibiti Malaria was awarded in 2022 - 2027 to Population Services International, with a focus on improving case management and malaria in pregnancy (MIP) services, improving the ability of individuals to practice positive health behaviors.

● Breakthrough Action was awarded in 2017 - 2023 to Johns Hopkins Center for Communications Programs to support social and behavior change activities.

● PMI Vector Link was awarded in 2017 - 2023 to Abt Associates

● Shinda Malaria was awarded in 2022 - 2027 to Ifakara Health Institute

● The Global Health Supply Chain Project - Procurement and Supply Management was awarded in 2016 to Chemonics International

● The Vector Works project was awarded in 2014 to Johns Hopkins Center for

Communications Programs

Information on these programs is available through their websites as well as on USAID’s Development Experience Clearinghouse (DEC), which is updated with programmatic and progress reports from each mechanism.

Link to GoT

USAID expects the results and activities in the Recipient's MVCA Activity should be consistent with the following Tanzania strategy documents that can be found at the Ministry of Health, (MOH)

a) Health Sector Strategic Plan V (HSSP IV) (2020 -2025)

b) National Malaria Strategic Plan (2020-2025)

c) Zanzibar Malaria Strategic Plan (2018-2023)

d) Draft - Communication Strategy for Malaria Control Interventions (2020-2025)

e) Zanzibar Malaria Communication Strategy (2018-2023)

f) Malaria Surveillance, Monitoring and Evaluation Plan (2015-2020)

g) Malaria Diagnostic and Treatment Guideline (2020)

Objectives, Illustrative Activities, and Illustrative Results

The purpose of the activity is to identify and implement proven, evidence-based vector control approaches in Tanzania, in support of reducing the overall malaria burden, and moving Tanzania closer to malaria elimination. The anticipated results of the award are to:

Objective 1: Improved access to Insecticide-Treated Nets (ITNs) Improving access to ITNs is a major component to this award. MVCA’s first objective includes implementation and technical assistance for ITN distribution through continuous distribution (e.g., school net distribution, distribution at facilities during ANC and EPI) as well as targeted mass replacement campaigns. MVCA will work closely with the NMCP and other partners to quantify the appropriate quantities, cadence, and channels to maintain ITN coverage targets as mandated by the NMCP’s malaria strategic plan, and to monitor ITN access over time. Activities under this objective may include:

Illustrative Activities

● Accurately estimating annual ITN needs

● Delivering ITNs through identified distribution channels. Distribution channels may include:

o Health facility-based distribution: Distribution through health facilities, where ITNs are given to pregnant women (at first ANC visit), and infants (when receiving the first measles rubella vaccine) at health facilities. Other groups such as elderly people and people living with HIV/AIDS may receive ITNs through health facilities.

o School net distribution: ITNs are delivered on an annual basis to identified classes; number of classes to receive nets may be adjusted to achieve coverage targets. School net distribution is in Mainland only.

o Targeted mass replacement campaigns: ITNs are delivered to communities when access drops below 40%, in hotspots of demonstrated moderate to high transmission, as a response to an emergency, or other criteria.

● Monitoring ITN availability

Illustrative Results

● Maintained ITN availability in line with national malaria program targets.

● Improved population access to ITNs.

● Annual quantification/estimates of ITNs need.

● Strengthened local capacity to implement ITN distribution via continuous distribution and targeted replacement campaigns.

Objective 2: Consistent and correct use of ITNs and other vector control interventions MVCA’s second objective promotes the consistent and correct use and care of ITNs and other vector control interventions. Activities under this result will align with and amplify the NMCP’s SBC and Advocacy Strategy to increase adoption and practice of malaria prevention behaviors among individuals, households, and communities in target geographies and health care providers at all levels of the health system. Activities under this objective may include:

Illustrative Activities:

● Creation and deployment of SBC materials including:

o Mass media activities (e.g., radio spots) and social media activities at the national and regional levels o Mid media activities (e.g. brochures posters) o Interpersonal communication activities (e.g., such as small group dialogues, cultural theaters)

● Mobilization activities at community levels

● Implementation of surveys to track performance of behavioral determinants across all interventions.

Illustrative Results

● Increased targeted populations’ knowledge, understanding, and acceptance of consistent ITN use.

● Improved targeted populations’ access to and appropriate utilization of ITNs.

● Enhanced mitigation against potential misuse of ITNs.

● Improved targeted populations’ care of ITNs.

Objective 3: Data driven selection of and approaches to vector control interventions, informed by entomological monitoring and high-quality technical assistance. MVCA’s third objective pertains to collecting, analyzing, and disseminating entomological and other data to help monitor the effectiveness of vector control interventions and inform strategies and implementation. Activities under this objective may include:

Illustrative Activities

● Entomological monitoring o Insecticide susceptibility testing of relevant vector mosquito species to guide selection and rotation of insecticides for vector control interventions.

o Vector bionomics monitoring to inform selection and timing of vector control interventions which exploit vector behaviors as well as to evaluate their quality and impact; this will include monitoring of An. stephensi.

o Maintenance of well-characterized mosquito colonies, including susceptible and where possible resistant strains derived from local populations, to enable insecticide susceptibility testing and quality/performance assessments of vector control interventions.

● Using entomological and other data to create evidence-based strategies, policies, and guidelines.

● Providing expert technical assistance to NMCP and ZAMEP on other vector control interventions, including but not limited to: IRS implementation, larval source management, attractive targeted sugar baits, spatial repellents, housing screening/modification. It is not anticipated that the partner will be responsible for directly implementing such interventions but rather provide technical assistance and guidance on the proposed plans or approaches for the adoption of any of these interventions, ensuring that guidance is driven by evidence.

Illustrative Results

● Annual entomological report produced.

● Evidence-based vector control strategy or guidelines updated or generated.

● Strengthened local capacity to analyze and utilize entomological and other relevant data for vector control decision making.

Other Considerations:

Private Sector Engagement

In line with the Tanzania CDCS, USAID anticipates significant opportunities for private sector engagement through this award. Private sector engagement may include:

Illustrative Activities

● Distribution of ITNs

● Private sector company provision of malaria vector control interventions (e.g., providing

ITNs or IRS to staff, or engagement and promotion of SBC activities)

● Use of private drug outlets (estimated to be around 17,000) to be utilized as distribution networks and/or customer education networks.

● Market segmentation analysis to determine the market share of ITNs available in the commercial sector.

● Private company sponsorship of activities such as marathons for malaria awareness.