Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya

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dc.contributor.authorMacharia, Peter M
dc.contributor.authorOdera, Patroba A
dc.contributor.authorSnow, Robert W
dc.contributor.authorNoor, Abdisalan M
dc.date.accessioned2021-10-08T07:08:19Z
dc.date.available2021-10-08T07:08:19Z
dc.date.issued2017
dc.description.abstractBACKGROUND: In high to moderate malaria transmission areas of Kenya, long-lasting insecticidal nets (LLINs) are provided free of charge to pregnant women and infants during routine antenatal care (ANC) and immunization respectively. Quantities of LLINs distributed to clinics are quantified based on a combination of monthly consumption data and population size of target counties. However, this approach has been shown to lead to stock-outs in targeted clinics. In this study, a novel LLINs need quantification approach for clinics in the routine distribution system was developed. The estimated need was then compared to the actual allocation to identify potential areas of LLIN over- or under-allocation in the high malaria transmission areas of Western Kenya. METHODS: A geocoded database of public health facilities was developed and linked to monthly LLIN allocation. A network analysis approach was implemented using the location of all public clinics and topographic layers to model travel time. Estimated travel time, socio-economic and ANC attendance data were used to model clinic catchment areas and the probability of ANC service use within these catchments. These were used to define the number of catchment population who were likely to use these clinics for the year 2015 equivalent to LLIN need. Actual LLIN allocation was compared with the estimated need. Clinics were then classified based on whether allocation matched with the need, and if not, whether they were over or under-allocated. RESULTS: 888 (70%) public health facilities were allocated 591,880 LLINs in 2015. Approximately 682,377 (93%) pregnant women and infants were likely to have attended an LLIN clinic. 36% of the clinics had more LLIN than was needed (over-allocated) while 43% had received less (under-allocated). Increasing efficiency of allocation by diverting over supply of LLIN to clinics with less stock and fully covering 43 clinics that did not receive nets in 2015 would allow for complete matching of need with distribution. CONCLUSION: The proposed spatial modelling framework presents a rationale for equitable allocation of routine LLINs and could be used for quantification of other maternal and child health commodities applicable in different settings. Western Kenya region received adequate LLINs for routine distribution in line with government of Kenya targets, however, the model shows important inefficiencies in the allocation of the LLINs at clinic level.
dc.identifier.apacitationMacharia, P. M., Odera, P. A., Snow, R. W., & Noor, A. M. (2017). Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya. <i>Malaria Journal</i>, 16(1), 174 - 177. http://hdl.handle.net/11427/34554en_ZA
dc.identifier.chicagocitationMacharia, Peter M, Patroba A Odera, Robert W Snow, and Abdisalan M Noor "Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya." <i>Malaria Journal</i> 16, 1. (2017): 174 - 177. http://hdl.handle.net/11427/34554en_ZA
dc.identifier.citationMacharia, P.M., Odera, P.A., Snow, R.W. & Noor, A.M. 2017. Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya. <i>Malaria Journal.</i> 16(1):174 - 177. http://hdl.handle.net/11427/34554en_ZA
dc.identifier.issn1475-2875
dc.identifier.ris TY - Journal Article AU - Macharia, Peter M AU - Odera, Patroba A AU - Snow, Robert W AU - Noor, Abdisalan M AB - BACKGROUND: In high to moderate malaria transmission areas of Kenya, long-lasting insecticidal nets (LLINs) are provided free of charge to pregnant women and infants during routine antenatal care (ANC) and immunization respectively. Quantities of LLINs distributed to clinics are quantified based on a combination of monthly consumption data and population size of target counties. However, this approach has been shown to lead to stock-outs in targeted clinics. In this study, a novel LLINs need quantification approach for clinics in the routine distribution system was developed. The estimated need was then compared to the actual allocation to identify potential areas of LLIN over- or under-allocation in the high malaria transmission areas of Western Kenya. METHODS: A geocoded database of public health facilities was developed and linked to monthly LLIN allocation. A network analysis approach was implemented using the location of all public clinics and topographic layers to model travel time. Estimated travel time, socio-economic and ANC attendance data were used to model clinic catchment areas and the probability of ANC service use within these catchments. These were used to define the number of catchment population who were likely to use these clinics for the year 2015 equivalent to LLIN need. Actual LLIN allocation was compared with the estimated need. Clinics were then classified based on whether allocation matched with the need, and if not, whether they were over or under-allocated. RESULTS: 888 (70%) public health facilities were allocated 591,880 LLINs in 2015. Approximately 682,377 (93%) pregnant women and infants were likely to have attended an LLIN clinic. 36% of the clinics had more LLIN than was needed (over-allocated) while 43% had received less (under-allocated). Increasing efficiency of allocation by diverting over supply of LLIN to clinics with less stock and fully covering 43 clinics that did not receive nets in 2015 would allow for complete matching of need with distribution. CONCLUSION: The proposed spatial modelling framework presents a rationale for equitable allocation of routine LLINs and could be used for quantification of other maternal and child health commodities applicable in different settings. Western Kenya region received adequate LLINs for routine distribution in line with government of Kenya targets, however, the model shows important inefficiencies in the allocation of the LLINs at clinic level. DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Malaria Journal LK - https://open.uct.ac.za PY - 2017 SM - 1475-2875 T1 - Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya TI - Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya UR - http://hdl.handle.net/11427/34554 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34554
dc.identifier.vancouvercitationMacharia PM, Odera PA, Snow RW, Noor AM. Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya. Malaria Journal. 2017;16(1):174 - 177. http://hdl.handle.net/11427/34554.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Geomatics
dc.publisher.facultyFaculty of Engineering and the Built Environment
dc.sourceMalaria Journal
dc.source.journalissue1
dc.source.journalvolume16
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12936-017-2009-3
dc.subject.otherANC utilization
dc.subject.otherLLINs allocation
dc.subject.otherEquity
dc.subject.otherResearch
dc.subject.otherSpatial modelling
dc.titleSpatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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