The Results Are In

The randomly selected villages
surveyed.

Nearly eight months since its initial inception, the project to evaluate last October’s bed net distribution has finally come to a close. We have trained five trainers, 53 Peace Corps Volunteers, and 141 Togolese counterparts, 198 villages were surveyed, 6,015 households visited, 36,471 people counted, and two papers written—one in French and one in English.

It was way back in February that the partnership between Peace Corps Togo and a number of organizations working in Togo was initially suggested.  With months of back and forth communication, but little progress towards actually cementing the relationship and beginning the project it felt like it would never come to fruition.  But alas, it is finally done!

Working with a number of large organizations and the government to establish a project was at times very trying.  While working with large international organizations can lead to a wide-reaching and successful project, sometimes getting everything going takes much patience. Four months past of back and forth e-mails before all parties involved could agree on a meeting. After the first meeting each partner had different comments on how things should be executed and some of those suggestions came as contradictions to each other.

Representatives from our partners who worked
with us on the piloting committee.

As we hoped to get moving on the project before the a large group of volunteers started to complete their service and leave the country, even after our second meeting things felt to be moving very slowly as we waited for the agreed funds to arrive.  As soon as our funding came in though, we were a flurry of activity with hardly two weeks passing before we began training for the survey.  Giving volunteers and their teams time to survey and submit their data it was a month and a half before we got started on our analysis.

While we found that the campaign did not quite succeed in its endeavor achieve “universal coverage” which is defined as one Long Lasting Insecticide-Treated Net (LLIN) for every 1.8 people, ending with one LLIN for every 2.22 people, we found other interesting results that showed the success of the campaign and where some improvement could be needed. The campaign did help to achieve the Plan National de Développement Sanitaire (National Health Development Plan) of 2012-2015’s goals of having 71.4% of pregnant women and 75.4% of children under-5 sleeping in Togo under a bed net, however, in my own region, Maritime, the goal was not achieved for pregnant women as net usage was lower in Maritime than the other regions.

Before the campaign only 40% of households owned even one net, but after the distribution over 93% of households had received at least one net.  Close to 75% of bed nets were hung up for use and a little over 71% of people surveyed reported that they slept under a net the night before, though in Maritime only 63% of people slept under a net..  Pregnant women and children under five years of age were more likely to sleep under a net than the general population.  As they are a target population because of their susceptibility to malaria, it is a positive sign to see that they are sleeping under bed nets—likely indicating that previous efforts directed at them have had some success.

People’s knowledge of malaria seemed to be pretty high and the majority of people were able to identify the correct cause of malaria, though even for some who gave the right answer they also gave an incorrect response, including drinking dirty water and working too hard in the sun, thus showing that there is room for improvement in education and that there may be a lack of understanding to as to how to differentiate between malaria and other fever causing illnesses.  Besides an insufficient quantity of nets, one of the main reasons for not sleeping under a net was that it wasn’t hung at the time, including that it was being wash, there wasn’t space in the house and that people did not know how to hang a net, further indicating the need for more education as to proper care and use of a bed net.

All of our results went into two papers that were presented to our partners.  We also gave a presentation of our results to Peace Corps administrators and attended a meeting with the Minister of Health, the Director of WHO Togo, and a representative of UNICEF. The last meeting that was on Monday rounded up the conclusion of our work. 

Now that we are done I feel very put-out.  We spent so many hours planning and executing the project that these few weeks before my next project begins have seemed very empty, though, I am exceedingly happy to be back in Vogan for a while.  My partners here have been very understanding of my work outside of Vogan, but now we are very excited to refocus on our projects here at home.