Remarks This recommendation is limited to classes of ITNs currently recommended by WHO. As with ITNs deployed in more stable settings, WHO recommends that ITNs that are prequalified by WHO be selected for use in humanitarian emergencies. When considering deployment of ITNs in humanitarian emergencies, the infrastructure, access, logistical capacity and resources available must be taken into account, as these may influence the feasibility and cost of procuring and deploying nets.

Practical info In deciding whether to deploy ITNs in emergency settings, consideration must be given to whether ITNs are appropriate for that setting, taking into account vector characteristics, human behaviour and available infrastructure. ITNs are most effective where the principal malaria vector(s) bite predominantly at night after people have retired under their nets and where the mosquitoes are susceptible to the insecticides used to treat the nets. Data will need to be collected to assess whether these criteria are met. There may be more limited capacity to gather such data in humanitarian emergencies than in more stable settings. In addition to assessing whether ITNs are appropriate, consideration of the feasibility of deploying nets in a particular emergency setting is important. Depending on the infrastructure, access, logistical capacity and resources available, procuring and distributing nets may be more challenging than in more stable settings. Instability in such settings may challenge long-term planning and so result in shorter lead times and consequently higher costs. It is also important to determine whether the shelters or housing structures in such settings are suitable for hanging a net. In some situations, the structure may have nowhere to hang a net or it may be too small to adequately accommodate a net. Other considerations for the deployment, monitoring and evaluation of nets apply equally to emergency and non-emergency settings. Please consult the practical information under the WHO recommendations for the different ITN classes. However, as for collecting data to assess whether nets are suitable in an area, the feasibility and capacity to regularly collect information for M&E in emergency settings must be assessed.