PSI prevents malaria and saves lives through the social marketing of insecticide-treated mosquito nets (ITNs).

“The lives of some 500,000 African children might be saved each year from malaria, if nets treated with biodegradable pyrethroid insecticide were widely and properly used.” (WHO, 1996) In Abuja, Nigeria in 2000, African leaders agreed to the target of 60% ITN coverage of pregnant women and children under five by 2005. PSI is helping Africa towards this goal.

PSI’s “Coverage Plus” model for ITN social marketing aims to increase ITN coverage in line with the Roll Back Malaria target of 60% ITN coverage of pregnant women and children under five by 2005, agreed on by African leaders in Abuja, Nigeria in 2000. The “Plus” refers to the model’s active collaboration with the commercial sector to move towards a sustainable commercial market as consumer ability and willingness to pay increases as a result of directly experiencing the health and economic benefits of ITNs. PSI has devised the following strategies to overcome barriers to achieving the RBM target and establishing sustainable ITN supply:

Segmenting the market: PSI sells several products at different prices through diverse outlets to multiple target groups, increasing access to ITNs while maximizing cost recovery and engaging the commercial infrastructure.

Partnerships: PSI forms partnerships with commercial companies, NGOs and national malaria control programs to ensure coor-dination and maximize ITN distribution oppor-tunities.

Creating demand and promoting health: PSI’s branded advertising campaigns are complemented by generic communication aimed at increasing awareness about malaria risks. These messages are delivered through mass media and trained interpersonal com-municators, often working in remote rural areas.

Monitoring the market: A crucial element of the Coverage Plus model is a monitoring tool (composed of a series of indicators) that guides the evolution of program strategy consistent with maximizing ITN coverage and developing the commercial market.

ITNs are typically conical or rectangular in shape. Conical nets are easier to hang and fold up; ease of use is particularly important in small rooms where beds are used as seats or tables during the day. Rectangular nets hang from string or frames and are more spacious. Polyester is the most commonly manufactured fabric for nets. A sheeting border prevents tearing when the net is tucked under a mat, and at the top of a conical net, sheeting reinforces the weight-bearing apex. Fabric strength is measured in denier-the higher the denier, the stronger the fabric. The strongest synthetic fibers are 100 denier and nets made with fabric of 70 denier and above are durable. Generally nets of less than 70 denier are weak and tear easily so although they may be cheaper, they are a false economy and they do not last as long.

The synthetic pyrethroids are the insecticides used for treating ITNs. This is because they are the safest insecticides for humans. The most commonly used insecticides are deltamethrin, lambda-cyhalothrin, alphamethrin and cyfluthrin. When they are handled, stored, diluted and used correctly, they are not harmful to humans. However, they can harm fish and bees, so if there is any waste insecticide this should be poured into a pit latrine, not a river or pond.

With funding from UNICEF, the Danish and Dutch governments, the U.K. Department for International Development (DfID) and the U.S. Agency for International Development (USAID), PSI markets ITNs in Angola, Benin, Burundi, Burkina Faso, Cameroon, DRC, Ethiopia, Guinea, Kenya, Madagascar, Malawi, Mali, Mozambique, Rwanda, Tanzania, Togo, Uganda and Zambia.

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Asleep, a mother and child are protected by an insecticide-treated net.