School-Based Distribution of ITNs

SECTION A: INTRODUCTION

About the School-Based ITN Distribution Survey

ABOUT THIS SURVEY

The School-Based Distribution of Insecticide-Treated Nets (ITNs) is a key malaria prevention strategy implemented by the National Malaria Control Programme (NMCP) under the Ministry of Health (MoH) of Sierra Leone.

This digital survey tool captures real-time data on ITN distribution activities in primary schools across all districts. It collects enrollment data by class and gender, tracks ITN distribution, and automatically calculates coverage statistics.

CLASS-BY-CLASS TRACKING

Record enrollment and ITN distribution for Classes 1-5

GENDER DISAGGREGATION

Track boys and girls separately with automatic totals

AUTO-CALCULATIONS

Real-time totals, proportions, and coverage statistics

BUILT-IN VALIDATION

Ensures ITNs distributed cannot exceed enrollment

Instructions: Complete all sections accurately. Fields marked with * are mandatory. You can save drafts anytime and submit when ready.

SECTION B: SCHOOL PROFILE

School identification and location details

DISTRICT *

Please select a district

CHIEFDOM *

Please select a chiefdom

SECTION

Please select a section

NEAREST HEALTH FACILITY *

Please select a facility

COMMUNITY / TOWN / VILLAGE *

Please select a community

SCHOOL NAME *

Please select a school

HEAD TEACHER NAME *

Name must contain only letters

HEAD TEACHER PHONE *

Enter 9-digit phone number

Please enter a valid 9-digit phone number

DATE OF DISTRIBUTION *

This field is required

SECTION C: ENROLLMENT & ITN DISTRIBUTION

Enter enrollment and ITN data for each class

ITNs RECEIVED IN SCHOOL

TOTAL NUMBER OF ITNs RECEIVED *

Enter the total number of ITNs delivered to this school

This field is required

ITN TYPE(S) RECEIVED *

PBO (Piperonyl Butoxide) IG2 (Interceptor G2)

Please select at least one ITN type

Validation Rule: Number of pupils who received ITNs cannot exceed the number enrolled.

CLASS 1

Teacher Name *

Teacher Phone *

Enter 9-digit number

Number of Boys in Class 1 *

Boys in Class 1 that Received ITNs *

Cannot exceed number of boys in Class 1

Number of Girls in Class 1 *

Girls in Class 1 that Received ITNs *

Cannot exceed number of girls in Class 1

CLASS 2

Teacher Name *

Teacher Phone *

Enter 9-digit number

Number of Boys in Class 2 *

Boys in Class 2 that Received ITNs *

Cannot exceed number of boys in Class 2

Number of Girls in Class 2 *

Girls in Class 2 that Received ITNs *

Cannot exceed number of girls in Class 2

CLASS 3

Teacher Name *

Teacher Phone *

Enter 9-digit number

Number of Boys in Class 3 *

Boys in Class 3 that Received ITNs *

Cannot exceed number of boys in Class 3

Number of Girls in Class 3 *

Girls in Class 3 that Received ITNs *

Cannot exceed number of girls in Class 3

CLASS 4

Teacher Name *

Teacher Phone *

Enter 9-digit number

Number of Boys in Class 4 *

Boys in Class 4 that Received ITNs *

Cannot exceed number of boys in Class 4

Number of Girls in Class 4 *

Girls in Class 4 that Received ITNs *

Cannot exceed number of girls in Class 4

CLASS 5

Teacher Name *

Teacher Phone *

Enter 9-digit number

Number of Boys in Class 5 *

Boys in Class 5 that Received ITNs *

Cannot exceed number of boys in Class 5

Number of Girls in Class 5 *

Girls in Class 5 that Received ITNs *

Cannot exceed number of girls in Class 5

SECTION D: SUMMARY DASHBOARD

Auto-calculated totals, proportions, and coverage statistics

All values below are calculated automatically from the data you entered.

TOTAL ENROLLMENT

Total Boys in School

0

Total Girls in School

0

Total Pupils in School

0

TOTAL ITNs DISTRIBUTED

Total Boys Received ITNs

0

Total Girls Received ITNs

0

Total Pupils Received ITNs

0

ITNs Remaining

0

PROPORTION OF BOYS & GIRLS

Proportion of Boys

0%

Proportion of Girls

0%

BoysGirls

ITN COVERAGE RATES

Boys ITN Coverage

0%

Girls ITN Coverage

0%

Overall ITN Coverage

0%

CLASS-BY-CLASS BREAKDOWN

CLASS	BOYS	BOYS ITN	GIRLS	GIRLS ITN	TOTAL	ITN	COV %
Class 1	0	0	0	0	0	0	0%
Class 2	0	0	0	0	0	0	0%
Class 3	0	0	0	0	0	0	0%
Class 4	0	0	0	0	0	0	0%
Class 5	0	0	0	0	0	0	0%
TOTAL	0	0	0	0	0	0	0%

VISUAL SUMMARY

Enrollment by Gender

ITN Distribution by Gender

Coverage by Class

SECTION E: TEAM MEMBERS & SUBMISSION

Survey team details, GPS location, and signatures

SURVEY DATE *

This field is required

GPS LOCATION

Capturing GPS...

1. HEALTH STAFF *

Full Name *

Name must contain only letters

Phone Number *

Enter valid 9-digit number

Signature *

Signature is required

2. TEACHER *

Full Name *

Name must contain only letters

Phone Number *

Enter valid 9-digit number

Signature *

Signature is required

Informatics Consultancy Firm-Sierra Leone (ICF-SL)

SCHOOL-BASED DISTRIBUTION OF ITNs

SECTION A: INTRODUCTION

ABOUT THIS SURVEY

SECTION B: SCHOOL PROFILE

SECTION C: ENROLLMENT & ITN DISTRIBUTION

SECTION D: SUMMARY DASHBOARD

SECTION E: TEAM MEMBERS & SUBMISSION