The Tanzania National Voucher Scheme (TNVS) is a public-private partnership that supports local industry while tapping into the strengths of the private sector in order to achieve a public health objective.
All pregnant women in Tanzania, upon their first pre-natal care visit, are entitled to receive a voucher that can be redeemed from a retailer for a bednet. The voucher is worth the equivalent of $2.50 redeemable for a bednet (which is sold for between $3 and $10, depending upon quality and size).
Pregnant women are particularly susceptible to malaria, which can result in low birth weight, and anemia, which contributes to maternal mortality. When newborns and many young children can sleep with their mothers under bednets, they are protected as well.
The Ministry of Health worked with the producers and distributors of nets in Tanzania to establish a program whereby retailers could accept the voucher in return for a share of the price, remit the vouchers to a wholesaler in return for additional nets to sell. The wholesalers are then reimbursed by the TNVS for each voucher.
The private sector has been much more capable at distribution than the public sector. One hundred seventy-four wholesalers are now engaged in the scheme; and 3,773 retailers had signed up to the voucher scheme by the end of March 2006, of which 80 percent are new to the insecticide treated net business. These sellers are reaching parts of the country and into communities where nets were previously unavailable. Commercial sales of ITNs in Tanzania in 2005 reached over 2.4 million, an increase of 34 percent over the previous year. Although pregnant women were specifically targeted, access to nets has improved for all.
A social marketing program complements the TNVS, disseminating knowledge about malaria and creating demand for bednets. To date, almost 1 million vouchers have been redeemed for nets, protecting an additional 1 million women and their children. More than 80 percent of women who receive a voucher use it to purchase a net.
As a result of the program, clinics have experienced increased attendance, with many women attending earlier in their pregnancies than was the case prior to the introduction of the scheme.
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