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30 The Province has had sustained high coverage of insecticide-treated mosquito nets (ITNs) since 2007.
When an infant vaccination strategy is adopted, there is need for sustained high coverage so as to ensure the susceptibility of adult women is not increased [ 17].
The sustained high coverage of VAS and other essential child survival interventions may have contributed to under-5 moreductioneductinn in the country, from 214/1,000 live births in 2005 to 200/1,000 in 2008 and to 185/1,000 in 2011.
Sustained high coverage of annual treatments with ivermectin is necessary, making long-term commitment important.
However, Sri Lanka [ 4], Latin America [ 5], Romania [ 6] and South Korea [ 7], experienced outbreaks of measles in spite of sustained high coverage with single-dose vaccination strategy.
However, even with such adjustments, it appears evident that the standard block in-service trainings cannot be the answer for sustained high coverage.
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As increasing numbers of national programmes attain and sustain high coverage of indoor spaces with IRS or ITNs, complementary strategies are increasingly needed that extend insecticide coverage beyond the house, and indeed beyond humans.
Key strategies of the plan include programmes to achieve and sustain high coverage with 2 doses of MMR vaccine administered at 12 15 months and 5 6 years of age, implement a nationwide 'catch-up' vaccination campaign, and strengthen measles surveillance.
If the projected rounds do not occur or do not sustain high coverage in the general population while also consistently reaching the under-vaccinated subpopulation, then we could see a different path with a resurgence in cases.
Here we show for the first time that "keep up" programmes relying exclusively on sales of modestly subsidized nets can achieve and sustain high coverage of entire populations with bednets, even without any complementary "catch up" mass distribution component.
The study was conducted in the poorest malaria endemic areas in Kenya [ 32] to explore barriers to ownership and use of ITNs among the poorest populations before and after the campaigns, to identify strategies for improving coverage and to make recommendations on how to sustain high coverage levels.
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