Felix Minuku, MD, MPH, Technical Coordination, SANRU III Basic Rural Health Project, Ave. de la Justice, Kinshasa-Gombe, Congo-Kinshasa, 8944142, felixminuku@sanru.org and Larry Sthreshley, DrPH, MPH, Missionary with PC(USA), SANRU III Basic Rural Health Project, Ave. de la Justice, Kinshasa-Gombe, Congo-Kinshasa.

The impact of insecticide-treated mosquito net (ITN) on reducing malaria morbidity and mortality malaria has been well documented. However, strategies for subsidization and distribution of ITNs are still being debated. In DR Congo, the SANRU III project is testing distribution strategies through existing primary health care activities.

Pre-natal clinics (CPN) and growth monitoring clinics (CPS) for children under five years of age have are popular and well attended components of Congo’s integrated PHC program. Generally, 50-60% of pregnant women attend at least one pre-natal session. The SANRU project has opted to encourage CPN with the addition of preventive treatment for malaria and the distribution/sale of ITNs at a nominal cost of $1.50 US.

Because of the limited number of nets currently available, the project has opted to link ITN distribution during growth monitoring clinics to children who complete their vaccination schedule, rather than to an immediate distribution of nets during the first CPS visit. This is also helping to synergistically improve routine vaccination coverage. The project found that most infants are sleeping under bednets received by their mother during the CPN.

After one year of testing in ten pilot health zones, attendance at CPN and CPS clinics has increased to more than 80%. The project has found that acceptance of ITNs starts off slow in rural areas, but increases as a critical mass of people buy the nets. The biggest restraint to expanding ITN distribution remains the financing for nets to continue the subsidized distribution strategy.

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