Remark: The GDG determined that a conditional recommendation should be given for house screening because of the low- to moderate-certainty evidence of an impact against malaria. Furthermore, programmes would need to consider a number of local contextual factors when considering screening of residential houses as a public health strategy, such as:

• how the intervention will be delivered and maintained;
• whether the structure and condition of the residential houses in the community allow for the installation of screening;
• the feasibility and resources needed for implementation, especially if deployed on a large scale. Programmes should note that this recommendation addresses the use of screening of windows, ceilings, doors and/or eave spaces, and does not cover other ways of blocking entry points into houses.

Practical info If house screening is being considered as a means to prevent malaria, it is important to identify who the end-user will be and how the intervention will be implemented, i.e. whether screening of houses will be a tool that the programme promotes for individuals or communities to implement at their own cost, or whether it will be undertaken as a programmatic initiative. Depending on the approach, the resources needed, feasibility, uptake and impact on equity may vary and would need to be considered. Screening of houses may be done post-construction or could be a standard feature for new homes. Intersectoral collaboration, for example, between health, housing and environmental sectors, is crucial in the implementation of house screening. It is also important to consider what standards and criteria, if any, need to be set for screening materials and designs, as they are for buildings. Screening of residential houses should be part of an IVM approach as promoted under the GVCR [15]. Deployment of interventions recommended for large-scale deployment (such as ITNs or IRS) should be maintained, and communities should be encouraged to continue using ITNs regularly or allow their houses to be sprayed, even if screening has been installed. In settings where national or local government authorities are not able to provide screening of residential houses as a public health strategy (e.g. due to feasibility/resource challenges), they should promote its use in affected communities. If house screening is deployed or adopted by communities to prevent malaria, post-distribution monitoring of the intervention is needed to assess material durability, usage and coverage. This information should guide how regularly screens require replacement or repair and provide information on the sustainability of the intervention.