262973 Exploratory assessment of alternative use of bed nets within the Arisi zone in Ethiopia: Findings from household interviews and observations

Wednesday, October 31, 2012

Hibist Astatke, PhD , C-Change, FHI360, Washington, DC
Celeste Marin, MPH , Consultant, Dublin 4, Ireland
Eskinder Tenaw, MSc , FHI 360, Addis Ababa, Ethiopia
Shoa Girma, MPH , C-Change, FHI360, Addis Ababa, Ethiopia
Thaddeus Pennas, MS , C-Change, FHI360, Washington, DC
Background: Distribution of long lasting insecticide-treated nets (LLINs) is one of four malaria prevention interventions being scaled up in sub-Saharan Africa. Correct and consistent use of LLINs by households is central to the success of such interventions. Use of ITNs for purposes other than sleeping is often described anecdotally, but almost no studies have examined alternative use systematically.

Purpose: The objectives were to determine the prevalence of alternative use of bed nets, and to provide recommendations for designing related communication activities.

Methods: Interviews and observations were conducted in 138 intervention and 140 comparison households, with the help of the female head of household. LLIN distribution was accompanied by Social and Behavior Change Communication activities within the past two years in the intervention but not comparison area. Two-stage cluster sampling was used to select communities and households.

Results: Alternative use was higher in comparison than in intervention communities. Alternative uses included ways likely to provide some protection against malaria (as bedding, curtains) and ways unlikely to provide any protection (as rope, to cover grain). A higher proportion of protective alternative uses was observed in the comparison group. Nets were used correctly in more than twice as many intervention as comparison households.

Discussion: The results suggest that intervention efforts are positively influencing alternative and correct use. Further refining existing communication strategies is recommended for ongoing SBCC programs with low to moderate alternative use. Examining the prevalence and determinants of correct use, non-use and alternative use is essential for all programs.

Learning Areas:
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the current state of systematic research on prevalence of alternative use of ITNs List example Social and Behavior Change Communication (SBCC) activities Explain why it is important to examine the prevalence and determinants of correct, alternative and non-use of bed nets when designing communication programs that promote use of ITNs

Keywords: Behavioral Research, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently overseeing research, monitoring and/or evaluation studies for Social and Behavior Change Communication malaria prevention and control programs in two countries in Africa. I have over ten years of experience conducting applied research, monitoring and evaluation studies for behavior change malaria and HIV prevention programs in developing country settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.