Category: Net Maintenance
Suggested audience: Everyone
Source: Senegal
Net Repair and Care Event Tourney
Background
This event was based off of the one done for World Malaria Day eventin 2012. It was repeated in September and October of 2012 in 20 different villages in the Kolda region of Senegal.

Materials

-25 sewing needles per event (buy extra to compensate for lost needles)

-1 large bar of peanut soap per 6 nets

-6 medium sized wash basins

-20 meters of thick rope (for hanging the nets)

-36 clothes pins

-Monitor and Evaluating sheets

-1 large spool of string (usually enough for 50 nets)

-Benches and chairs (as available to you)

-Mats/ground coverings for the repair station

-(Optional) 1 Radio/Music + Extra Batteries – Not necessary, but definitely improved the atmosphere

Set up

-Ask the hosting volunteer to invite their village and to pick a location near a water source, lots of shade and some place to hang the rope for drying the nets.

- Clean and sweep the area prior to the event.

-Fill the wash basins with water and set them up in a circle near the water source. Place a quarter of a bar of soap on each basin.

-Set up several chairs and benches around the perimeter, as is available to you.

-Run the rope between branches of a tree to be used as lines for the nets to dry. Make sure you have enough lines, otherwise people resort to hanging their nets on fences and in the sun.

-Cut the string into 1-2meter long pieces to hand out.

-Cut each bar of soap into four pieces and keep nearby to refill the soap at the wash station.

-Have drinking water available near the check-in station.

Process

Have four stations set up: Check-in, net repair, washing, and drying.

*When someone arrives at the event, they must first “register” their nets with a volunteer. See below.

After the nets are all registered, they are given a needle and a meter of string to repair their net. If they do not know how to sew, a local health worker or volunteer will assist.

When the net is fully repaired, the needle should be returned. The participant should then be directed to the washing station.

When the nets are all washed and rinsed, the participants should be directed to hang their nets on the line. Have a bag of clothes pins near the drying area. They can also bring their nets home to dry with directions to hang it on a line in the shade.

Throughout the event, local music was playing in the background. I think people really enjoyed singing along and dancing while they worked with their nets.

**About half way through the event, a local health worker held and educational question and answer session for about 20 minutes regarding malaria.

Additional Notes

-Most events were held in the morning- they usually ran from 9 AM to 1 PM.

-The educational portion was generally held after everyone had been checked in but had not yet left. This was not a good way to time it- it frequently did not happen. However, when we tried to run it before the participants usually asked us to postpone it until they were ready, but then they left to go make and eat lunch.

-I ended up biking with all of the materials to the majority of the participating villages. The soap and wash basins weighed the bike down a lot and also made it quite unstable. If this is your main means of transportation, I would recommend going to villages with well maintained bush paths or near to the road.

*Monitor and Evaluating

Name:______

*DHS specific

** CDC/USAID?

If this home-visit being conducted with a community health worker/counterpart, please write his/her name**:______

Initial Survey

Does your household have (enough) useable mosquito nets to sleep under*? ______

If not, why* (circle)?

Not enough money

Not necessary

Use other means of protection

They are no mosquitoes

Do not like mosquito nets

Not sure

Other

For how many months/years have you slept under a mosquito net/ *?______

How many months of the year do members of your family sleep under mosquito nets(0-12)*?______

If you sleep outside of the bedroom (e.g., in a courtyard), do you and your family sleep under a net*? ______

Do the members of your household sleep under mosquito nets all-year-round*? (circle: Y / N )

If not, why (circle)*?

Not a lot of mosquitoes

Because of the heat

Do not like mosquito nets

Forgetfulness/negligence

Other

Ask the interviewee and others present if they will show you how they hang their net(s).

Number of people able to demonstrate how to correctly hang a net**

Total <5
Total 6-14
Total 15-17
Total 18+

Total number of nets at household and total number of people sleeping under each net

Net #: / 1 / 2 / 3 / 4 / 5
# of people <5 who slept under this net last night:
# of people 6-14 who slept under this net last night:
# of people 15-17…
# of people 18+…
# of pregnant women who slept under this net last night
Net #: / 6 / 7 / 8 / 9 / 10
# of people <5 who slept under this net last night:
# of people 6-14 who slept under this net last night:
# of people 15-17…
# of people 18+…
# of pregnant women who slept under this net last night

Total <5: ______

Total 6-14:______

Total 15-17:______

Total 18+:______

Total Pregnant Women:______

If there are pregnant women in the compound, encourage them to get their babys’ ‘malaria medication’ (IPTp) at the nearest health post.

Total # of pregnant women encouraged to use IPTp**:______

Why, last night, did members of your family not sleep under a mosquito net*?

No mosquitoes

Heat

Torn net

Net is not effective

Not sure

Other: ______

PRE TEST-Net Repair

1) What do you do if your net is torn? (Sew or tie the hole)______

2) Why is it important to repair tears or holes in nets? (Mosquitoes do not enter through holes)______

3) Do you know how to sew holes? (knows what to do when handed needle and thread)______

Holes
Net / Net Age / 0-2cm / 2-5cm / 5-10cm / 10-15cm / 15-20cm / 20+cm / Repaired Prior?
1
2
3
4
5
6
7
8
9
10
Comments [Were there concentrations of hole locations? Where? Hole types (puncture vs. tears vs. wear)?]:

POST TEST- Net Repair

1) Understands the importance of closing holes in net (if sew all holes, mosquitoes cannot enter)______

2) Demonstrates the ability to sew at least one hole in a net (have old torn net available for people to sew if no holes in their net)______

Total number of people trained in net-repair/exposed to training**:______

PRE TEST- Net Washing

1) How do you wash nets? (more gentle than normal cloths but with non-hot water)______

2) How many times per year do you wash your net*? When do you wash your nets? (3-4 times/year, or after rainy, cold, and dry seasons)______

3) What do you wash your net with? (peanut soap)______

4) When was the last time this net was washed* (answer in months: if more than a year ago, write 12)?______

4) How and where do you dry your net? (in the shade, not on a fence likely to tear it?)______

POST TEST- Net washing

1) Understands manner of washing (softly, as to not tear net)______

2) Understands correct frequency of washing (3-4 times/year)______

3) Understands which soap to use for washing nets (peanut soap and not omi/madar)______

4) Understands nets are to be hung in the shade to dry and not on fences likely to tear the net?______

Total number of people trained in net washing/exposed to this training**:______

**Educational Session Questions

What is malaria?

Parasitic disease that is in your blood

It is treatable and preventable

How do you get malaria?/ How is malaria transmitted?

Malaria is transmitted ONLY by mosquitoes

How is malaria transmitted? (showing how one person infected with malaria can transmit it to another person)

1) A person with malaria has the malaria parasite

2) A mosquito bites the sick person. This mosquito draws the persons blood with the malaria parasites.

3) Now the mosquito has the malaria parasites.

4) The mosquito goes and bites a healthy person.

5) The mosquito deposits the malaria parasites in the body of the healthy person.

6) Now that person has the malaria parasite.

7) That person will soon be sick with malaria.

How is malaria known? I.e. how do you know if you have malaria?/How can the malaria parasite be identified?

You can be tested for malaria for FREE at the health post or health hut with a rapid diagnostic test

If someone is sick with malaria, what will the body do? I.e. what happens to the body when you're sick with malaria?

The symptoms of malaria include:

Fevers that come in cycles

How does the fever present?

The fever can give the illusion that the patient has gotten better

The fever will periodically abate and return

Headache

Chills

Vomiting

Muscle Aches

If you recognize the symptoms of malaria or as soon as a person has a fever, what should you do?

go quickly to a health facility for an RDT

How is malaria treated?/ What medicines treat malaria?

If you have the simple form of malaria (palu-simple), the medicine is called ACT (Coratem) and it is FREE

If you have the complicated form of malaria (palu-grave), the primary medicine is called Quinine and it is not free.

What is the name of malaria medicine?

Emphasize that the name of the medicine that treats malaria is ACT and NOT paracetamol- Mention that different medicines affect different parts of your body and different diseases. If you want malaria, specifically, to go away, you need to take ACT (assuming its in its simple form) and you need to take ALL OF IT. The medicine is not effective if all of the pills are not taken.

The complicated form of malaria is treated with many medicines that can total over 20,000 FCFA. The primary medicine is called Quinine. If you go to the health post as soon as you start experiencing symptoms, you will only need to pay the cost of the consultation because it is in its simple form. If you wait, it will become more expensive.

World Vision has a health insurance program that involves paying 500-1000 FCFA annually and from then on, all of your medicines will only cost 150 FCFA.

How can a mosquito net save you money?

1) If a person sleeps under a net, mosquitoes cannot bite her in the net.

2) If a person if not often bit by mosquitoes, she will not often be sick with malaria.

3A) If a person is not sick with malaria, she will not often spend money on medicine.

3B) If a person is not sick with malaria, she can go to work to earn money.

How is malaria protected against? I.e. how do you prevent malaria?

Bed Nets (Long Lasting Insecticide Treated Nets/LLINs)

IPTp- a prophylactic drug given to pregnant women during prenatal consultations (SP)

Indoor Residual Spraying (insecticide spraying that occurs in several districts)

Immediate diagnosis/treatment

What should you do with the mosquito net after you get up in the morning?

roll it up over itself over the bed

if the net is over a floor sleeping space, take it down for the day and retie it in the evening

How is a LLIN washed?

It is washed gently with non-detergent soap

No more than four times a year

How is a LLIN hung to dry?

It is hung on a line, in the shade. NOT over a fence or any other place where it could acquire new holes.

Is it ok to wash a LLIN with bleach?/ Is it ok for you to wash a LLIN with bleach?

It is NOT ok to wash LLINs with bleach or with ‘oumo’

Is it ok for a LLIN to be hung in the sun?/ Is it ok for you to hang a LLIN in the sun?

It is NOT ok. They should be hung in the shade.

Where should a mosquito net be hung?

Anywhere a person sleeps, any sleeping space

Inside and outside

Over a standing bed, over a floor sleeping space, over an outside stoop/bench

How can a pregnant woman get a mosquito net?

(where/ how) at her first prenatal visit

(cost) besides the cost of the consultation ticket, she will be given one net for free

How is a net repaired?

It is repaired using a needle and thread

Patch

Who needs to sleep under a net?

EVERYONE

When during the day should a net be hung?

The nets should be hung in the evening and remain hung until the morning

When during the year should a net be hung?

It should be hung year-round, due to the fact that you can get malaria at any time of year

Where can malaria medicine be gotten? I.e. Where can you get malaria medicine?

Malaria medicine is distributed from and sold by pharmacies.

How will a sick person who has gone to the hospital get a cheap net?

They will receive a ticket during their consultation. They can redeem that ticket with the pharmacist for a 500 FCFA net.