Nov 13 - 17, 2016
WHY NO NETS? AN IN-DEPTH INVESTIGATION INTO THE DECREASE IN NET ACCESS ON BIOKO ISLAND AFTER BEDNET DISTRIBUTION
Thomas C. Stabler1 , Dianna Hergott1 , Guillermo Garcia1 , Aveika Akum1 , Chris Schwabe1 , Immo Kleinschmidt2
1 Medical Care Development International, Silver Spring, MD, United States, 2 London School of Hygiene & Tropical Medicine, London, United Kingdom
From December 2014 to June 2015, the Bioko Island Malaria Control Project (BIMCP) conducted a mass-top up LLIN distribution campaign on Bioko Island, Equatorial Guinea. Despite good reported coverage (88% of households received at least 1 LLIN), results from the BIMCP’s 2015 Malaria Indicator Survey (MIS) reported low levels of net ownership (69%) and low net access (32%) approximately 7 months following distribution. While the distribution campaign ensured that one net was distributed per sleeping area, achieving an average of one net per 2 residents in 88% of households, a better understanding of the reasons behind the reduction of nets is needed to allow BIMCP to implement strategies against a decrease in net access in future campaigns. An initial analysis of MIS questions regarding net ownership indicated that a high proportion of households reported a dislike of the net (16.2%), while other households reported giving them to relatives on the mainland (12.7%). A mixed quantitative and qualitative study will be performed to determine the reasons behind the reduction in bed net access. A random sample of 150 households on Bioko Island will be selected from BIMCP's Campaign Information Management System (CIMS) and MIS databases. These databases use a GIS-based household mapping system, used to easily locate and track every household location to be sampled. A semi-structured interview will be employed to determine participant household's current net access relative to the number of nets distributed during the campaign and the number of nets reported in the subsequent MIS, what happened to the nets that were lost and the reasons why, current net usage by household member type (e.g. under-5's, pregnant women, etc.), their knowledge and attitudes acquired from the distribution teams and/or other media about LLINs, and their perceptions about the distribution process. The analysis will seek to discern what the primary reasons are for the unexpected decrease in net access. Findings will inform the BIMCP on how to reduce the LLIN loss rates, in planning for the upcoming 2017 LLIN distribution and for future continuous distribution.