Background: Nigeria, in its quest to scale up coverage and utilization of\nLLINs as a strategy for malaria control, had the first long lasting insecticidal\nnet (LLIN) mass campaign across the country between 2009-2013. The NMEP\nwith support from its RBM partners successfully distributed over 57.7 million\nLLINs during the period representing over 90% of the national target. In spite\nthis, and to achieve universal coverage, the country maintained a continuous\ndistribution through multiple channels and in particular the antenatal care\noutlets and the expanded programme on immunization. The Nigerian government,\nwith support from the Global Fund and through the National Malaria\nElimination Programme (NMEP), Catholic Relief Services (CRS), and the\nSociety for Family Health (SFH) and with technical support from the World\nHealth Organization, once again launched the LLIN replacement campaign in\nsome states across the country. Methods: A cross-sectional survey was conducted\nin five states that conducted the LLIN replacement campaign using the\nlots quality assurance survey (LQAS) tool developed by the World Health Organization.\nThe period of the survey across the states is between August and\nDecember 2017. The LQAS questionnaires were administered to households\n(HHs) by the WHO field officers trained on the use of the tool at least one\nweek after the campaign. A total of 240 HHs were selected from 24 settlements\n(clusters) in 24 wards of six LGAs (lots) from each of the five (5) states\nthat rolled out the campaign. Data collected were double entered, cleaned,\ncrosschecked, and the results analysed using the SPSS version 24. Results:\nWith a total of 9740 people surveyed from 1200 HHs across the five states, the\naverage redemption rate was 95.5% (95% CI, 91.6% - 98.8%), average retention rate was 98.4% (95% CI, 97.0% - 99.8%), average hanging rate was 82.6%\n(95% CI, 80.0% - 85.5%), and an average card ownership of 83.5% (95% CI,\n78.6% - 88.2%). While the main source of information 35.4% (95% CI, 21.8% -\n49.0%) about the LLIN campaign was the health workers, the reasons for\nthose missed out were mainly due to team performance 32.2% (95% CI, 26.8%\n- 37.4%) and net cards not issued 27.4% (95% CI, 23.2% - 32.0%). Similarly,\nthe Pearson correlation (0.942, �± 0.017, p < 0.05, 2-tailed test), the ANOVA\ntest (F value of 23.751, �± 0.017, p < 0.05), and Regression analysis (R-square\n0.888 and Durbin-Watson 2.487), all shows significant relationships between\nLLIN redemption and usage with a resultant rejection of the Null Hypothesis.\nConclusion: The outcome of this research underscores the need to adopt and\nscale up the use of the LQAS tool to assess the quality of LLIN campaigns\nwithin the shortest possible time. While the LQAS has been in use by the\nWHO Expanded Programme on Immunization cluster during polio campaigns,\nthis is the first time that the tool was deployed by the WHO malaria\nunit as a strategy to identify post LLIN campaign gaps immediately after implementation.\nThe scaling up of this strategy would undoubtedly improve LLIN\ncampaigns that would be conducted in the remaining states across the country so\nas to ensure that Nigeria achieve LLIN universal access in line with the Global\nTechnical Strategy (GTS) framework toward malaria elimination.
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