ITN-Oriade - Nigeria

ITN-Oriade was designed with the broad goals of reducing the mortality and morbidity due to malaria in communities (with a focus on women and children) participating in the Oriade Initiative in South West Nigeria adopting a multi-method approach incorporating applied research, home-based management of simple malaria, strengthening of referral systems for malaria control, education on the use of insecticide treated materials and community engagement in all processes for malaria control. This component of the initiative is implemented in 12 local governments in Oyo, Osun, Ekiti and Ogun States. All activities are community owned through programmes of co-financing, co-management and local monitoring for impact assessment/evaluation with technical assistance provided to the community and the local government by the Center for Health Sciences Training, Research and Development (CHESTRAD). The B zone of the United Nations Children's Fund (UNICEF) has supported implementation of the ITN-Oriade initiative.

Activities of ITN-Oriade

Implementation of ITN-Oriade is based on a composite of the following activities:

1. Community advocacy and consensus building dialogues to understand local perceptions, current management practices for simple malaria and local issues in the promotion of insecticide treated materials
2. Survey of local health facilities to assess existing infrastructure and manpower capacity for the management of complicated and severe malaria
3. Annual yearly cross-sectional survey of malaria prevalence and use of Insecticide treated materials. A baseline survey has been conducted in participating sites. This survey was implemented during the peak of the malaria transmission season between June - August, the period of the rainy season. This is based on findings that highest prevalence of simple malaria is reported at this time, and acceptability of insecticide treated materials is most favored during this period of high transmissibility (Personal Communication, National Vector and Malaria Control Program)
4. Selection and training of village based agents to recognize, treat simple malaria, identify signs of danger, refer cases of simple and other forms of malaria as appropriate and mobilize the local community for control activities
5. Identification and strengthening of focal referral facilities to provide support to local communities by the management of referred cases
6. Strengthen and/or establish public sector-local community partnership for primary health care using malaria as a focal disease
7. Promote sustainability via income generation activities based on local production of insecticide treated materials
   

Health, Economic Development.

The guiding principle of implementation is to build communal capacity to direct the control of simple malaria.Based on the findings from the community advocacy and consensus building dialogues, various IEC and training materials have been developed. These include:

i. Radio Jingle titled 'Ala re re' (Sweet dreams) to communicate the ability of the bed nets not only to prevent mosquito bites but also to reduce their nocturnal nuisance value and ensure sound sleep

ii. A six-episode video based radio drama series also titled 'Ala re re' showing different aspects of the management of simple malaria and its control. These video series are played during community advocacy dialogues and have been very useful in passing on key messages on the use of insecticide treated bed nets and the role of local households and families in community directed management of simple malaria.

iii. An illustrated instructional booklet on malaria and insecticide treated bed nets 'Myths and facts about malaria and insecticide treated bed nets' has been produced and is being widely circulated in the participating communities.

iv. An illustrated instructional guide 'Community Directed Management of Simple Malaria and Promotion of the Use of Insecticide Treated Bed Nets: Manual for Community Orientation and Advocacy Dialogues'. This guide has been used for the training of village based agents, members of local development committees and the local health authorities on community-directed malaria control programs.