GWWC Team

Against Malaria Foundation shares details about their post-distribution monitoring survey process

This guest post from AMF explains why and how their team conducts post-distribution surveys to monitor impact.

A spotlight on Against Malaria Foundation's Post-Distribution Survey (PDM) process

Against Malaria Foundation's work is surprisingly simple. They distribute bed nets to households in need, reducing the death toll from a huge killer of children under 5: malaria. 

The results? Tremendous. With a $5 net, a fatal bite can be prevented. A child can live. Households who can't access medical care because of location or situation have free ammunition against one of their biggest public health threats.

Against Malaria Foundation (AMF) has long been one of our 

 — so we thought our readers might be interested in hearing about a lesser-known aspect of their work: post-distribution surveys. 

 It's when AMF — through partnerships with local organisations —  visits a selection of the households that received nets and follows up on net condition and usage, allowing the AMF team to adapt, iterate, and monitor their programs for maximum impact. 

We asked AMF to share some details about this important part of its work. Here's what they said.


From Planning to Field Work: How the Monitoring Process Works

Malaria remains one of the world's most persistent public health challenges, with an estimated 250 million cases occurring annually. Despite being preventable and treatable, this mosquito-borne disease continues to claim an estimated 600,000 lives each year, primarily among children under five and pregnant women in sub-Saharan Africa.

The Against Malaria Foundation (AMF) works to reduce this burden by distributing long-lasting insecticide-treated nets (LLINs) in universal coverage campaigns. This is possible thanks to donations from generous people around the world. 100% of donations go to buy nets. For example, a $10 donation funds approximately five nets that will protect 10 people when they sleep at night.

Through partnerships with implementing organizations and national health ministries, AMF has distributed over 190 million nets to protect more than 350 million people from malaria. Each net distribution is carefully planned with accountability measures in place to ensure that nets go where intended. An example of this is digital data collection at household level during distribution. The information collected on smartphones or tablets accurately documents how many nets each family needs and receives. This enables universal coverage - typically one net for every two people - ensuring that entire regions can sleep protected from the bites of malaria-carrying mosquitoes.

AMF recognizes that distribution is just the beginning of effective malaria prevention. To verify that nets reached the households and continue protecting people over their expected 3-year lifespan, AMF partners with local organizations to conduct Post-Distribution Monitoring (PDM) surveys. These PDM surveys take place at regular intervals - typically at 9, 18, and 27 months after distribution. They track four key indicators: net presence (whether distributed nets remain in households), coverage (how many people sleep under nets), usage (whether people use the nets correctly), and condition (whether nets remain effective). AMF has conducted 150 PDM surveys across nine countries, collecting data from 2.4 million households across diverse and often challenging environments.

Above: Publicly shared 1-page report presenting results of PDM conducted in Akwa Ibom state, Nigeria.

For each monitoring round, AMF randomly selects villages and households across the entire area that has received nets, ensuring that no regions are excluded. This pre-selection process creates a fully random, unbiased sample — critical for reliable results. Even the most remote or difficult-to-reach households are included, preventing the monitoring from focusing only on convenient locations that might not represent an overall situation.

Above: Rebuild Hope for Africa data collector navigates a muddy rural road during post-distribution monitoring in Bas Uele, DRC

After arriving at a village, data collectors locate the selected households and obtain permission from the residents to conduct the interview. Once permission is granted, the interview can begin. One of the first steps involves capturing household GPS coordinates. While the household location is never publicly shared, the GPS coordinates provide an important layer of data quality verification. By comparing the data collector's current location with the coordinates recorded during distribution, supervisors can confirm that the correct households are being visited. This geographic validation is particularly valuable in areas without formal systems of household addresses.

During the interview, the electronic form guides the data collector through a standardised flow of questions. At each household, information is collected about the household composition and the sleeping arrangements and each present net is physically assessed. The questionnaire’s skip-logic functions streamline the interview by tailoring questions based on previous answers. For example, if a respondent indicates they have nets that are present but not hung, the form presents follow-up questions about reasons for non-use. This adaptive questioning reduces the complexity of the interview by ensuring only relevant questions are displayed, making the process more efficient and less confusing for both data collectors and respondents. By streamlining the interview experience in this way, the platform encourages more accurate and complete responses, improving the quality of the collected data.

Above: Net Assessment - Uganda PDM9 (implemented by Team Initiatives Limited)

Above: Net Assessment - Nigeria, Zamfara state PDM9 (implemented by eHealth Africa)

Throughout the process, there are multiple mechanisms that help to ensure there are no mistakes in the collected data. As an example, the questionnaire’s validation features ensure consistency and completeness of the responses. With partners, AMF has built into the system automatic checks to confirm responses make logical sense — for instance, checking that when a household reports receiving five nets during distribution but only has three now, they provide reasons for what happened to the missing two. If inconsistencies are detected, the data collector is alerted before progressing to the next question. Another mechanism is the 5% verification process, where a different set of data collectors go back to a random selection of 5% of the previously interviewed households, with no knowledge of the data previously collected. As both sets of data collectors ask the same questions, the answers can be compared. When the same key information is recorded in both visits, this indicates a reliable data collection. These systems give us confidence that the results of the PDM are accurate and so can feed into decisions and actions. At the end of the survey, all data is shared with national malaria programmes.

This monitoring system allows AMF to verify the impact of their distributions. The household-level data collected across thousands of communities provides a realistic picture of distribution effectiveness and shows how nets are being used in real-world settings. The evidence gathered through this process serves multiple purposes. It allows AMF to report with confidence to donors on the nets they have funded. This accountability and transparency builds high levels of confidence in AMF’s work. Additionally, by sharing the results with in-country partners, AMF can help to inform actions and policy adjustments based on this data.

More on AMF"s work

Founding one of the world's most effective charities | Rob Mather, AMF

Giving What We Can announces its plans for 2025 and beyond. 

Announcing our 2025 strategy

We are excited to share a summary of our 2025 strategy, which builds on our work in 2024 and provides a vision through 2027 and beyond!

 (GWWC) is working towards a world without preventable suffering or existential risk, where everyone is able to flourish. We do this by making giving effectively and significantly a cultural norm.

 we have made our pledges – and in particular the 🔸

 We know the 🔸10% Pledge is a powerful institution, as we’ve seen almost 10,000 people take it and give nearly $50M USD to high-impact charities annually. We believe it could become a norm among at least the richest 1% — and likely a much wider segment of the population — which would cumulatively direct an enormous quantity of financial resources towards tackling the world’s most pressing problems.

We initiated this focus on pledges in early 2024, and are doubling down on it in 2025. In line with this, we are 

 we were previously running and which are not consistent with our new strategy.

 (BHAG) of 1 million pledgers donating $3B USD to high-impact charities annually, which we will start working towards in 2025.

1 million pledgers donating $3B USD to high-impact charities annually would be roughly equivalent to ~100x GWWC’s current scale, and could be achieved by 1% of the world’s richest 1% pledging and giving effectively. Achieving this would imply the equivalent of nearly 

Over the coming years, we expect to test various growth pathways and interventions that could get us to our BHAG, including digital marketing, partnerships with aligned organisations, community advocacy, media/PR, and direct outreach to potential pledgers. We think it’s likely that multiple of them will be needed to achieve our ambitious goal and that they will complement and strengthen each other if implemented well. Hence, rather than selecting only one or two interventions and doubling down, over the next few years we will iteratively build GWWC’s capacity to excel at various growth interventions to convert new audiences.

By the end of 2027, we aim to have built a portfolio of mutually reinforcing scalable pledge growth engines, and to have doubled our current pledge community.

Laying the foundations for scalable growth

To build such a portfolio, GWWC needs highly capable growth and operational divisions. In 2025, we will lay these foundations.

This includes recruiting top-tier Chief Operating and Chief Growth Officers with experience scaling similar products and organisations; preparing our operational, governance and grantmaking systems for scale; and improving our understanding of pledge funnels and target audiences.

We will also test various new pledge growth interventions, improving and expanding on our existing portfolio.

Last but not least, we will put in place tracking and guardrails to ensure we “scale responsibly”: maintaining the quality of the pledge in terms of pledgers giving effectively and significantly, and staying true to effective giving principles and our 

 last year, but we’re only at the start of our journey: with our renewed pledge focus and BHAG, we’re looking to grow our annual impact 100-fold and make significant progress towards a world without preventable suffering or existential risk, where everyone is able to flourish.

Why 1M pledgers rather than just an amount raised? 

We could have chosen a $3B USD donated effectively as our sole BHAG, but we have intentionally included the 1M pledger number since our mission is to make effective giving a 

 (with expected associated longer-term benefits), and to not solely to raise a lot of money for high-impact charities in the short term or among a small group of people.

Who are we counting as a “pledger” towards our 1M goal? 

In this case, we are defining “pledger” as someone who has taken 

this includes anyone who has taken the 10% Pledge, Trial Pledge, Further Pledge, Company Pledge, or any other pledge(s) we might launch. Currently, our 10% Pledge makes up >80% of our pledges and pledge donations, and our hypothesis is that it’s the most promising path to scaling our impact, but this is something we intend to keep questioning.

 Very roughly, we define these as “among the highest-impact donation options by some plausible worldview”. Importantly, this leaves room to include highly effective donation options that are outside GWWC’s recommendations and/or aren’t in line with the worldviews of the GWWC team. As part of our regular impact evaluation, the GWWC research team determines the bar for what qualifies here and reports on associated estimates.

Announcing our 2025 strategy 

Giving What We Can is a community of effective givers. We support each other by learning and sharing information about effective giving. We aim to create a culture in which people are inspired to give more, and give more effectively.

GWWC Team

About

Articles

A spotlight on Against Malaria Foundation's Post-Distribution Survey (PDM) process

Announcing our 2025 strategy