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Balaka, Malawi, 6-month post-distribution check up report added

Monday, 20 October 2014 13:49 by General
The key results from the post-distribution check-up (PDCU) of net use and condition are:

- 87% of nets hung, 70% in ‘very good’ condition. 25% in ‘OK’ condition
- 4,530 households (5% of those that initially received nets) and 7,977 nets were surveyed
These are strong results.
We publish the full PDCU results and the PDCU Report as well as the PDCU Planning Document on the Balaka distribution page.
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396,900 nets on the way to Dowa District, Malawi

Tuesday, 7 October 2014 15:17 by General

396,900 nets have shipped and will arrive in Dowa district in the middle of November for distribution from Dec14/Jan15 to protect 720,000 people and achieve universal coverage.

Our distribution partner Concern Universal will carry out the distribution.

AMF is funding both net and non-net costs, as was the case with the Balaka (2013) and Dedza (2014) distributions. We describe publicly the circumstances in which we cover non-net costs for a distribution.

A cost-driver led budget has led to detailed costings and we publish full budget details. Actual costs will be published at the end of the distribution.

The non-net cost per net is US$0.97. This covers shipping, pre-distribution activities (a district-wide household level registration to establish sleeping space net need), distribution and post-distribution follow-up (six, six-monthly check-ups of 5% of households, randomly selected and visited unannounced, carried out for three years post-distribution). 


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Ntcheu, Malawi 33-month post-distribution check-up will start on 13 Oct 14

Wednesday, 1 October 2014 17:36 by General
Monitoring net use and condition is an important element in optimising the protection of a population at risk from malaria.
This will be the fourth post-distribution check-up (PDCU) of net use and net condition in Ntcheu, Malawi following the June 2012 net distribution that achieved district-wide universal coverage of the population of some 550,000 people.
To date the results have been strong and we are keen to see the usage level and condition of the nets 33 months after they were distributed.
9,500 households, representing approximately 7% of those that received nets 33 months ago, will be randomly selected and visited unannounced.
The results will assist the District Health Officer (DHO) and National Malaria Control Programme’s (NMCP) decision as to when a re-coverage campaign should be conducted in Ntcheu so the people of Ntcheu remain protected.
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Distribution of 676,000 nets underway in Kasaï Occidental Province, DRC

Tuesday, 30 September 2014 16:03 by General

This distribution will achieve universal coverage in seven Health Zones in the Kasaï Occidental Province of Congo (Dem. Rep.), across a population of some 1.2 million people.

The distribution is being carried out by IMA World Health, with the UK Government’s Department of International Development (DFID) as a co-funding partner.

This will the first stage of a two stage net distribution approach that has the specific objective of maintaining sleeping space coverage at or above 80% for a period of four years.

The second stage will involve continuous monitoring of net use and condition, and also net gaps, with additional net distribution as appropriate via 'routine distribution' mechanisms.

In addition, 6,000 nets will cover all hospital and maternity beds across all health facilities in the seven Health Zones.


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Distribution of 245,000 nets underway in Dedza district, Malawi

Monday, 29 September 2014 16:28 by General
245,000 nets are now being distributed in Dedza district, Malawi. All nets will be distributed by the end of October.
These nets will protect some 440,000 people, helping to achieve universal coverage of all sleeping spaces in the district.
Pre-distribution work led by our distribution partner, Concern Universal Malawi, and carried out with the local government health teams, has involved visiting all 162,723 households in the district to establish net need per household. This allows an efficient, targeted distribution with each household receiving the number of nets each needs.
This pre-distribution activity allows significant engagement of community and health leaders in the net distribution process and associated malaria education elements. Community involvement is instrumental in ensuring an organised distribution and helping to achieve high levels of immediate net hang-up and sustained use.
Detailed distribution records, including household level data, will allow us to verify nets were distributed as intended. Independent supervision at the ‘moment of distribution’ ensures no nets are misappropriated.
The data collected during the pre-distribution phase will be used in the six-monthly post-distribution net use and condition check-ups, when 5% of households are selected at random and visited unannounced to gather net use and condition data. These (anonymised) data are made public, allowing us to report on the levels of net use achieved over time. The District Health Officer (DHO) and his/her team are able to use this health-centre level information to influence additional local malaria control interventions as they deem necessary.
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Behind the scenes

Wednesday, 2 July 2014 16:37 by General
We have added Behind the Scenes to the Transparency section of the site.
We show this information to be transparent but also for those who might be interested in some of the things that go on behind the scenes in managing the charity.

Many of AMF's systems are automated. This means many activities are handled very efficiently requiring only a few minutes of oversight each month. Importantly, it also means we are able to do things we would otherwise not be able to do because they now require minimal resources. 
Topics we have covered, many of which include live data, are:

  1. Allocating donations to distributions
  2. Reporting on Post-Distribution Check-Ups (PCDUs)
  3. Managing Gift Aid
  4. Converting and locking all donations in US$
  5. Sending personal thank yous to donors
  6. Monitoring new donations 

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An update on distributions being assessed

Wednesday, 2 July 2014 16:21 by General
We have just updated our future distributions page showing the progress made in approving seven distributions. 
In the coming several months we will be parallel assessing a number of distributions of 1 to 2 million nets in size and possibly one of 3 to 4 million nets in size.
You can view the current status of each distribution with visual and summary updates.
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Distributions update, June 2014

Wednesday, 25 June 2014 13:15 by General

We have made a US$6m commitment to four distributions in Malawi over four years and on Idjwi Island, DRC. The same level of accountability, achieved through distribution verification and post-distribution follow-up, applies to these as to previous distributions.

A provisional, large distribution in a province of the DRC will not proceed as the distribution agent was unable to agree to the process requested by AMF in the timeframe needed by our co-funding partner.

Of the $14.8m in-hand, we have now confirmed spending of $8m leaving $6.8m for further distributions.

Approved distributions

1. Malawi

This set of distributions extends AMF’s planning horizon, increases the number of districts within which AMF will take responsibility for mass distributions and allows us to continue monitoring net use and malaria data in the coming years.
We have made a US$5.6m commitment to four distributions over four years in Malawi totalling 1.4 million nets to protect 2.5 million people.
  • Dowa District, November 2014, 400,000 LLINs
  • Ntcheu District, October 2015, 350,000 LLINs
  • Balaka District, October 2016, 235,000 LLINs
  • Dedza District, October 2017, 430,000 LLINs
The addition of Dowa district brings to four the number of districts (of 28 in Malawi) where AMF is responsible for funding.
Our distribution partner Concern Universal has demonstrated the commitment and capability to carry out successful mass distributions achieving high rates of net coverage in our previous work in Malawi. We will continue to use the same distribution methodology.
The timing of these distributions reflects the expected life of nets in these districts following the initial 2012 (Ntcheu), 2013 (Balaka) and 2014 (Dedza) work. Returning to these areas allows efficient monitoring of net use and collection of malaria data. Our processes are continually revised to ensure the most effective results.
The precise number of nets will be calculated on completion of the household level pre-distribution surveys.

2. Democratic Republic of Congo (DRC)

120,000 nets will achieve universal coverage on the island of Idjwi in eastern DRC
AMF has approved a 120,000 net universal coverage distribution on Idjwi Island working with Amani Global Works (AGW). A 60,000 net distribution will take place during November 2014 in North Idjwi. We have been impressed with AGW's experience in North Idjwi and their commitment to accountability and transparency. Both parties will review the North Idjwi distribution once completed and intend to carry, out shortly thereafter, a similar universal coverage distribution in South Idjwi.
Provisional distribution not proceeding
We are not proceeding with provisional plans for a third and larger distribution in DRC. Within the timeframe needed by our co-funding partner, the distribution agent was unable to agree to the process requested by AMF. While we remain ready to adapt our practices to different environments, we are seeking to improve on standard net distributions. This is because we have found significantly higher levels of hang-up when these improvements have been implemented. 
We fully understand that not all distribution partners will share our priorities or wish to make changes to their normal routine. After extensive discussions we did not reach agreement on the detailed aspects of verification of the distribution or monitoring and evaluation within the timeframe necessary to secure a firm commitment from our co-funding partner. During the negotiation, significant budget cuts were also placed on our co-funding partner.
This was intended to be our largest DRC distribution after the successful conclusion of negotiations for the distribution of 676,000 LLINs earlier this year with a different distribution partner, IMA World Health. These took one month and  included swift agreement on distribution verification, monitoring and evaluation. AMF and IMA believe that the detailed follow-up checks which have become a feature of AMF work significantly improves net hang-up rates.
We recognise this can and should be adapted to take into account the country and regional requirements, so detailed discussions will sometimes be necessary to find an agreed outcome. However, we are reviewing this experience to learn from it and in particular assess how to reduce the risk of important differences arise late in the process. A Letter of Partnership Principles was agreed by the three parties at the start of discussions, which included a clear commitment to the inclusion of monitoring and evaluation activities. This did not prevent differences being raised on these issues late in the process.
We are also considering whether future distributions should focus on three to four distributions of one to two million nets each rather than a large distribution that would require all of AMF’s available funds. This would allow AMF more flexibility to exit discussions earlier if differences arise.
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Encouraging early stage progress with candidate malaria vaccine PfSEA-1

Friday, 23 May 2014 10:38 by General
There is encouraging news about progress with a potential malaria vaccine, PfSEA-1.
A study in Tanzania took regular blood samples from a group of 1,000 children living in a highly malarious area, in the first years of their lives. 6% of these children developed a naturally acquired immunity to malaria. They produce an antibody that attacks the malaria-causing parasite.
What is particularly interesting about this candidate vaccine is the source of the compound being investigated: antibodies found in humans. This is different from many candidate vaccines which do not have a ‘starting point’ in humans. This may be an indication of a higher probability of a positive outcome at the human trials stage where proof is required of both the efficacy and safety of the vaccine.
The research team said they were encouraged by the results but stress more research is required. Trials are now needed in primates and humans to fully assess the vaccine's promise.
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Malawi, Balaka District: net use assessment 6-months post-distribution

Thursday, 1 May 2014 09:16 by General

The 6-months post-distribution net use check-up (PDCU) is currently being conducted in Balaka District, Malawi.  Five percent of households, randomly selected, across 14 health centre catchment areas in the district were visited, unannounced, to assess net use and condition.

The data are being entered in Malawi now and may be viewed in real-time. As soon as all data have been entered we will publish a summary of the results.

The specific nature of the data - at the health centre level - means the District Health Officer (DHO), health centre leaders, community leaders and other health workers are able to decide what targeted malaria control intervention might be appropriate in specific areas. In circumstances where health systems and resources are stretched, information that assists with targeted interventions can help with effective use of resources and that is the aim of this information.

Background: Almost 160,000 LLINs were distributed in Balaka District in October and November 2013.

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