Malawi 2015-16

The ownership and use of both treated and untreated mosquito nets is the primary prevention strategy for
reducing malaria transmission in Malawi. The Malawi Ministry of Health adopted the distribution of ITNs
as one of the major malaria control interventions in 2005. The 2011-2016 National Malaria Strategic Plan
aims to achieve universal coverage with ITNs, defined as one net for every two people, with the objective
of increasing net ownership and net usage among pregnant women and children under age 5 to at least 90%
by 2016 (NMCP 2011). The ITN policy includes free distribution of ITNs for pregnant women at their first
visit to an antenatal care (ANC) clinic and for newborn babies in health facilities at delivery or at their first
clinic visit under the Expanded Programme on Immunisation (EPI) if an ITN was not received at birth. The
policy also supports time-limited, national, free distribution campaigns. Malawi implemented a nationwide
universal access campaign in 2012, during which 5.6 million nets were distributed countrywide. In
December 2014, 1,158,968 ITNs were distributed during the first phase of the 2014-2015 national
campaign. Six districts (Nkhotakhota, Mchinji, Likoma, Mwanza, Neno, and Phalombe) were targeted in
this mini-campaign based on the time elapsed since
they were covered under previous campaigns
(NMCP 2015). However, the implementation of the
remaining phases of the 2014-2015 ITNs mass
distribution campaign was postponed until 2016.
In the 2015-16 MDHS, 63% of households have at
least one mosquito net, and 57% have at least one
ITN. On average, there are 1.1 ITNs per household
(Table 12.1). Thirty-two percent of households
received mosquito nets from mass distribution
campaigns, 17% from ANC visits, 11% from health
facilities at delivery of newborn babies, 3% from
immunisation visits, and 16% at government health
facilities during other visits (Table 12.2 and Figure
12.1).
Figure 12.1 Source of ITNs
Percent distribution of ITNs in interviewed
households
Mass campaign
ANC
At birth
Immunisation visit
Other government
health facility visit
Shop/market
Other
3
7
11
14
17
16
32
About one in five households in Malawi (24%) has
achieved full household ITN coverage, which means
that they have one ITN for every two persons who
stayed in the household the night before the survey;
one-third of households (33%) have at least 1 ITN
but not enough ITNs for all household members,
while 43% of households do not own any ITN
(Figure 12.2).
Figure 12.2 Household ownership of
ITNs
Percent distribution of households
At least 1
ITN for
every 2
people in
the HH
24%
At least 1
ITN, but
not enough
for all HH
members
33%
No ITN
43%
184 • Malaria