Long-lasting, Insecticide-treated Nets (LLIN) Scale-up and Hang-up Programme

This guide is designed for all Red Cross and Red Crescent National Societies who are implementing long lasting, insecticide-treated net (LLIN) distribution programmes. It outlines strategies for the distribution and promotion of LLINs, including complementing distribution with training and awareness campaigns. The guide explains that whether distribution occurs as part of integrated health campaigns or through standalone activities, a key problem is ensuring proper use of nets once distributed. An important part of ensuring correct and consistent use is communication, such as health promotion on the transmission and prevention of malaria, house-to-house visits to promote hanging, and social mobilisation to encourage community involvement.
The first step in the distribution campaign is preparatory planning in coordination with the national Ministry of Health (MOH) and other partners. This can involve preparing a plan of action, as well as securing funding for the campaign. The guide explains that there should be only one national plan of action, which the National Society should be involved in developing through the coordinating structure. The MOH should take the lead in overseeing the overall implementation of the plan. Once the national plan of action and stakeholders’ roles are clarified, National Societies should develop their own action plan, including information mapping and assessment. This will then inform planning for distribution activities at the district level. Distribution planning should include mapping detailed information about the demographics, community activities, and distances related to the distribution, as well as mapping distribution points. Along with other considerations to ensure orderly distribution, the guide suggests that a demonstration net be hung to facilitate explanations to recipients and that Red Cross Red Crescent volunteers wear t-shirts, bibs, and/or caps with suitable slogans for the campaign.
According to the guide, training must be undertaken for both supervisors and volunteers in preparation for the mass distribution of LLINs. It is advantageous if the MOH can co-facilitate the training in order to add technical expertise, improve the links between the two partners, and expose and update MOH staff on the Red Cross Red Crescent's hang-up and keep-up activities. The Red Cross/ Red Crescent training should incorporate messages which are specific to the organisation, as well as information on the management of volunteers, and financial and narrative reporting.
The guide states that behaviour change communication, social mobilisation, and advocacy are key components for successful LLIN distribution campaigns. Behaviour change communication is especially important for a successful campaign, as after receiving LLINs, the community must hang, use, and maintain nets effectively. Planning for social mobilisation at district level should be carried out well in advance of the campaign as part of the overall district level campaign planning. A communication plan is essential, incorporating behaviour change communication and social mobilisation, to promote healthy behaviours while contributing towards the creation of a supportive social environment. The campaign is likely to be successful when actions, messages, and materials are strategically planned and managed together.
Social mobilisation is most usefully designed for a range of individuals, families and communities, who are well positioned to pass on key messages. Before implementing the plan, it is important to pre-test the messages with the different groups. Messages need to be clear, easy to understand, and action-orientated. It is clear that "word of mouth" is central in informing and convincing beneficiaries of the importance of participating in the LLIN distribution, so it is very important to have both the participation of the community and its leadership in the campaign. Similarly, it is important to work through key administrative committees such as those that may have been formed during previous health campaigns and health activities.
As outlined in the guide, activities can include the following:

• Announce the days when the LLIN distribution will take place at all community meetings, religious gatherings, sporting, and cultural meetings. This can be through megaphones and the use of town criers.
• Undertake a media campaign - in particular, using the radio to announce distribution days and times, or use television announcements where possible.
• Radio and television are often expensive channels of communication. If the National Society is going to pay for radio messages, consideration should be given to key times that people are listening to the radio (i.e popular programmes, news broadcasts, etc.).
• National social mobilisation committees should work closely with the press and other media to plan dates, times, frequency, and content of media messages and press releases.
• Carry out house-to-house and school visits with clear messages on the importance of collecting a LLIN and correctly hanging and keeping it up.
• Make individual visits to key people, including religious, traditional, and political leaders to inform them about the campaign.
• Develop materials such as banners and bibs to identify Red Cross Red Crescent workers and their place of work during the campaign.

The guide also explains that hang-up activities can be built into the social mobilisation for the campaign (immediate post-campaign door-to-door activities), but is also an activity that can be used prior to peak transmission periods to ensure nets are hanging and used.