IRS on Wheels

Jul 2010
The PMI-funded Uganda Indoor Residual Spraying project conducts IRS campaigns in six districts in Northern Uganda.
 	Local members of Village Health teams served as spray operators in Northern Uganda. Source: Abt Associates Inc.

Reaching remote communities in Northern Uganda with an innovative approach to IRS delivery

Malaria is the leading threat to the health of Uganda's population and, according to the Ministry of Health, is responsible for approximately 40 percent of outpatient visits, 25 percent of inpatient visits, and nearly half of all deaths in children under five. Nearly 95 percent of Uganda's population lives in high-transmission areas and is exposed to the disease throughout the year. Indoor residual spraying (IRS) is the targeted application of long-lasting insecticide to the inside walls and the ceiling of houses in a community to kill the mosquitoes that cause malaria. The PMI-funded Uganda Indoor Residual Spraying project conducts IRS campaigns in six districts in Northern Uganda.

Spray operators head out on their bicycles for a day of spraying. Most homes they spray are far off the main road. Source: Abt Associates Inc.A large component of a spray operation's budget is spent on transportation, primarily truck hire. To test the idea of significantly reducing costs by shifting to bicycles for use by spray operators, the Uganda IRS project conducted a pilot in two subcounties in Kitgum and Pader Districts. The project paid spray operators $1 per day for the use of their bicycles as means of transport, rather than relying on vehicles supplied by the project. The use of bicycles was feasible because, instead of importing labor from neighboring subcounties, members of the Village Health Teams (local individuals working as volunteers for community health services) were recruited as spray operators, thus building the capacities of the districts at the village level.

Wearing his personal protective equipment, a spray operator prepares his pump for spraying after riding to a village in Kitgum, Uganda. Source: Abt Associates Inc.The pilot was successful: it cut the cost of spray operator transportation in half and was well received by the community and the spray operators, who were happy to rent their bicycles to the program for the extra income. In addition, using members of the local community increased the acceptance of IRS and increased coverage because their bicycles enabled spray operators to reach areas trucks could not access due to poor road conditions. Spray operators were able to cover their targeted houses each day without worrying about missing their ride back to the center of the spray operations. Renting bicycles from spray operators also meant that more operating funds were put directly into the local communities and spread across community members, rather than to an outside vendor for truck rentals. The Uganda IRS project replicated the exercise at the district level in other suitable areas in Apac and Oyam Districts.

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