Key Concepts and Terms

  • In this document we use the terms ’access’ and ‘ownership,’ rather than ‘coverage,’ to be clear that we are dealing with issues concerning ownership and access rather than use. While the level of use is crucial to impacting malaria transmission, this document only includes the mechanics of ITN distributions. Consider communication and other interventions, such as hang-up campaigns to improve use, separately.
  • Targets for reducing malaria are based on access to ITNs. When referring to targets and indicators, we often refer generally to ITNs rather than LLINs specifically. However, it is now recommended internationally, and in most countries, that only LLINs be distributed.
Channel The route through which the ITNs (or vouchers or coupons) flow to the end-user. Determining the final point when the user will receive an ITN is a good way to clearly understand the channel.
Civil society Nongovernmental (NGO), not-for-profit groups, including faith-based organizations, community-based organizations, and other groups registered as charities or NGOs (local or international).
Commercial ITN/LLIN sector The independent for-profit retail market for ITNs or long-lasting insecticide-treated bed nets (LLINs), with independent import, distribution systems, and sales points; includes formal and informal outlets.
Conventionally treated net An ITN that was treated within the past 12 months by dipping with one of the six insecticides recommended by WHO. To ensure the insecticidal effect, re-treat these ITNs after three washes or at least once a year. This type of net is no longer recommended by WHO.
Insecticide-treated net (ITN) An ITN that repels, prevents blood feeding, and/or kills mosquitoes after contact because of insecticide on the netting material. ITNs are either conventionally treated nets or LLINs.
ITN access A person has access to an ITN if that person has an ITN available to sleep under every night. Whether or not the person does sleep under the ITN is an issue of use, not access.
ITN coverage A term that can sometimes confuse the issues of ‘ownership’, ‘access’, and ‘use.’ Some literature describes levels of ITN use (i.e., what proportion of the population are ‘covered’ by ITNs). In other literature, coverage is interchangeable with ‘ownership.’ This document avoids the term ‘coverage’ as much as possible; and instead uses ‘ITN ownership’ or  ‘ITN access’, as appropriate to clearly communicate what is meant.
ITN ownership Having at least one ITN, whether or not it is used.
ITN strategy An overall plan for reaching and maintaining target ITN levels in the country, which outlines, among other issues, all the mechanisms used to achieve this.
ITN use Sleeping under an ITN at night. As an indicator, this is usually measured through large household surveys that ask, for a given net in the household, which household members slept under that net the previous night.
Long-lasting insecticidal net (LLIN) A factory-treated mosquito bed net with insecticide incorporated into or bound around the fibers, or a mosquito net treated with a long-lasting insecticidal treatment kit that retains its biological activity for at least 20 WHO standard washes under laboratory conditions and three years of recommended use under field conditions without re-treatment.
Macroplanning A plan to describe predicted commodity needs for each channel on an annual basis.
Mechanism The entire delivery system that results in a household receiving an ITN. A channel is part of the mechanism, but the entire mechanism includes other aspects, such as decisions on pricing, type of ITN, and procurement.
Microplanning A plan that estimates ITN need, by channel, at lower sub-national levels (by village, at lowest level).
Public sector Government sector (e.g., Ministry of Health [MOH] or Ministry of Education [MOE], often with support from international and bilateral donors, contractors, and NGOs).
Private sector Note: This website avoids referring to a ‘private sector,’ but instead refers to public, commercial, and civil society sectors to avoid confusing ‘private not-for-profit’ (included in the civil society sector) and ‘private for-profit’ (the commercial sector).
Pull mechanism A mechanism that requires the future ITN owner to take action to receive the ITN. The action must be specific to getting the ITN (such as going to a retail outlet) instead of something the person may do anyway (such as attending an ANC clinic). Most, but not all, pull mechanisms would mean the ITN has some cost to the user.
Push mechanism A mechanism that includes only limited action or no action from the future ITN owner to receive an ITN, and the ITN is given at no cost. As an example, mass campaigns ‘push’ ITNs to households, in predetermined quantities.
Routine or continuous channels Channels that already exist to provide other services and that may be adapted to include distributing ITNs (i.e. health facilities).
School-based ITN distribution Schools as a channel for ITN distribution, not just as a distribution point for mass campaigns.
Targeted Intended for a specific group, with ITN distribution designed to only address this group. The targeted group may be a specific biologically vulnerable group, such as pregnant women; other groups that need particular attention to maintain ownership (e.g., the poor), or specific geographical areas (e.g., the most remote).
Universal Coverage Based on the WHO Recommendations for Universal Coverage with Long-Lasting Insecticidal Nets in Malaria Control, in order to maintain universal coverage mass campaigns should distribute one ITN per two persons at risk of malaria and for procurement purposes many households have an odd number of members, so the calculation needs to be adjusted to 1.8 persons in the target populations.Two specific notes on terminology are included here: