By: Brigitte Smith
In order to eradicate Malaria in Tanzania, USAid should adopt a hybrid approach that works with health clinics to distribute a portion of Insecticide Treated Nets (ITNs) to children and populations that are most susceptible to malaria, while selling the rest through local shops at a low subsidized price. Large-scale operations of free handouts of ITNs succeed at covering a wide area of land very quickly, keeping low costs, and meeting short-term goals. However, they forego the greater potential for the development of the community and do not address the lack of health services that will sustain efforts against malaria and other infectious diseases in the long run. Based on information reported by the World Health Organization (WHO), mosquito nets need to be retreated and potentially replaced after three years. Therefore, to best serve the interest of the people in the long term, Tanzania needs a system that not only quickly distributes nets throughout the country and encourages residents to use of them, but also incentivizes citizens to continuously prioritize their health and provide facilities and skilled workers to meet the needs of the citizens that seek care.
Social marketing is a system that will instill desire and pride in having an ITN, especially since people perceive a purchased brand name item to be more valuable that a free giveaway. Coinciding with this human characteristic, providing the opportunity to buy and sell ITNs builds a sense of ownership in community members and has the potential to employ local residents. This method better contributes to community development. However, as with other cases, selling nets only provides for the need amongst the richest of the poor; thus, the problem amongst children would remain.
Thus, handouts must complement social marketing tactics. The desire to use the nets will exist from social marketing campaigns that educate citizens and the supply will be provided by handouts through health clinics to be most accessible to pregnant women and children. The ITNs provided in health clinics without a charge still contributes to community development, as receiving the gift of a net in a healthcare setting positively reinforced their visit to the clinic and builds a positive reputation for the health clinic in the community. This way, the net isn’t free. They had to earn it by investing effort to visit the health care facilities. Moreover, the interaction with the health facilities provides the opportunity to build trust with community members. This will encourage residents to return for other health issues and to request another net in the future.
However, in regard to the communities that do not have access to any health care facilities, distribution to their homes or other communal channels should occur until facilities are established. These endeavors should only be completed once the other channels of distribution are set up through social marketing. Once information is gather about which parts of the nation are not responding to the initiative, then volunteers should distribute in those communities. This way, selling channels are not undermined by any possible handouts.
Additionally, it is also a great opportunity for USAid and the government of Tanzania to collaborate. The employees of USAid should help bring attention to areas that still need health care facilities to the government so there are simultaneous initiatives to build healthcare facilities that can serve as a location to distribute nets. In all, Tanzania requests a three-part program: a temporary free distribution to the least developed, a distribution system aimed at pregnant women and child in health care facilities, and a social marketing initiative that trains locals to sell the nets and educate their neighbors about the importance, as well as proper usage techniques.
Kyama, Reuben , and Donald G. McNeil. “Distribution of Nets Splits Malaria Fighters.” New York Times, 9 Oct. 2007.
Strengths, Weaknesses and Recommendations for USAid
USAid has sufficient funds to address the malaria epidemic across the nation of Tanzania. They also have access to a plethora of qualified project consultants and staff that can coordinate the implementation of the project as well as permission from the government to work in their country. However, since the organization is adjoined to the U.S. government, they must use democratic processes, adhere to meetings, and achieve goals in a timely manner that may inhibit creativity, consume funds, and inhibit them from reaching certain populations in Tanzania. Since USAid hires through US based companies, they may miss opportunities to hire local respected representatives that readily know effective distribution channels without having to pay high fees for a consultant to conduct research on the communities. Employees may be overly specialized and may end up hiring more people than if they were to train and hire locals that are more flexible. According to the article from the New York Times, USAid used 95% of the budget on consultants and 5% on materials. So, while they have access to funds, they tend to mismanage their resources.
USAid should continue to use social marketing tactics as they proceed. However, they should rethink the use of funds from solely spending on supplies to investing in the community. Instead of establishing channels to simply sell mosquito nets, they should explore how they can contribute to community development initiatives that can incorporate the sale of mosquito nets. For the sake of efficiency, if people and resources travel to isolated communities, they should optimize their time and invest in financial/trade system that complements the distribution process of nets so they better contribute to the local economy. The consultants do not need to impose their method of sales onto the community, they should cater to the style of the community and work the nets into their system whether it be a barter or monetary system. More specifically, the many components to social marketing could be completed through multi-national corporations that employ locals and already have successful sales channels within communities. For example, first they could have the company distribute the nets to their employees and allow access to a discounted price for family and friends. This way the USAid does not have to hire as many consultants to research or establish channels to reach the community and the extra funds can go toward increasing supply. Also, it incentivizes community members to get a job so they have access to the nets and helps the businesses by improving the health of their employees. The underlying element is that USAid better collaborates with local business and utilizes preexisting channels to reach communities so that they invest their funds in the community.