Promotion of Mosquito Net Coverage and Equity for a Nomadic Pastoralist Community through Digitalization of a Mass Net Campaign in Turkana, Kenya

Background The use of Insecticide-treated nets (ITNs) is an effective malaria prevention and control intervention. Turkana County, which was recently classified as a high malaria burden region, faces unique challenges, including geographic remoteness, nomadic populations, and infrastructure limitations, which complicate the equitable distribution of ITNs. In 2024, ITNS were distributed through a digitalized campaign. This study aimed to assess ITN coverage and use following the campaign in Turkana County. Methods A cross-sectional household survey was conducted in two peri-urban areas: Loima and Lodwar. Household heads were interviewed to collect data on household characteristics, ITN ownership, and utilization. Data were analyzed using frequencies and proportions, and compared using chi-square tests to compare ITN coverage and utilization for the two areas. Results A total of 370 households were surveyed. About 57% of households in Loima had ≥ 7 members (mean, 7.5; SD, 3.0) compared to 46.8% in Lodwar (mean, 6.9; SD, 3.4). The equity gap for ITN ownership was not statistically significant. An equity gap of 21.4% points [72.7%; 51.3%, (χ² = 17.73, p < 0.0001)] was observed between Lodwar and Loima, respectively. In Lodwar, there was a statistically significant equity gap across household size, with more households among those with up to six members having sufficient ITNs than those with more than six members (79.5% vs 65.0%; χ² = 5.76, p  = 0.016). Respondents where ≥ 80% of residents had access to an ITN were about 26 times more likely to have slept under an ITN compared to those with < 25% access. In Lodwar, 11.4% of respondents with access to ITN did not utilize them. Conclusion The campaign resulted in high ITN coverage in both study areas, with better coverage achieved in the area that had not previously received a campaign. The campaign did not achieve equity across house types in Loima and household sizes in Lodwar. Tailored mass campaign approaches for hard-to-reach and nomadic populations, and complementary continuous distribution strategies are recommended to sustain universal ITN coverage and align with the WHO Global Technical Strategy (2016–2030) goals.