Closing the gap between insecticide treated net ownership and use for the prevention of malaria

Prog Community Health Partnersh. 2011 Summer;5(2):123-31. doi: 10.1353/cpr.2011.0018.

Abstract

Background: Malaria is the leading cause of morbidity and mortality in children younger than 5 years old and pregnant women in sub-Saharan Africa. Insecticide-treated nets (ITNs) reduce clinical malaria by more than 50% and all cause mortality in young children by 15% to 30%. However, use of these nets is poor across sub-Saharan Africa, limiting the potential impact of this effective tool in the fight against malaria.

Objective: We sought to improve the use of ITNs using a community-created and -implemented approach, and measure the change in ITN use over the year after implementation.

Methods: Using a community-based participatory research approach, we created and implemented an intervention to improve ITN use in a rural village. Our intervention involved providing hands-on instructions and assistance in hanging of nets, in-home small group education, and monthly follow-up by trained community members. ITN use was measured for all individuals in a subset of the community (61 households, 759 individuals) at baseline and at 6 months and 1 year after distribution.

Results: Rates of individual usage increased significantly from 29% at baseline to 88.7% (p < .001) at 6 months and to 96.6% (p < .001) at 12 months. For children under age 5, usage rates increased from 46% at baseline to 95.7% (p < .001) at 6 months and 95.4% (p < .001) at 12 months.

Conclusion: Our study demonstrates that rapidly achieving and sustaining almost universal ITN usage rates is possible using a community-based approach. Closing the gap between ITN ownership and use will help communities to realize the full potential of ITNs in the prevention of malaria.

MeSH terms

  • Adolescent
  • Adult
  • Child, Preschool
  • Community-Based Participatory Research / methods
  • Community-Based Participatory Research / organization & administration*
  • Female
  • Ghana
  • Health Promotion / methods
  • Health Promotion / organization & administration*
  • Humans
  • Malaria / prevention & control*
  • Male
  • Middle Aged
  • Mosquito Nets / statistics & numerical data*
  • Pregnancy
  • Pregnancy Complications, Parasitic / prevention & control
  • Rural Health
  • Young Adult