Abstract
BackgroundProlonging net durability has important implications for reducing both malaria transmission and the frequency of net replacement. Protective behaviour, such as net care and repair, offers promise for improving net integrity and durability. Given the potential cost-savings and public health benefit associated with extending the useful life of long-lasting insecticidal nets (LLINs), prevention and mitigation of damage will become ever more critical to ensuring adequate net coverage at the population level.MethodsA qualitative assessment was conducted in two districts in central eastern Uganda in September 2013. Data on household net care and repair behaviour, attitudes and practices were collected from 30 respondents through in-depth interviews (IDIs), observations, photos, and video to gather an in-depth understanding of these behaviours.ResultsNet damage was common and the most cited causes were children and rodents. Responses revealed strong social norms about net cleanliness and aesthetics, and strong expectations that others should care for and repair their own nets. Respondents were receptive and able to repair nets, though longer-term repair methods, such as sewing and patching, were not as commonly reported or observed. Self-reported behaviour was not always consistent with observed or demonstrated behaviour, revealing potential misconceptions and the need for clear and consistent net care and repair messaging.ConclusionsRespondents considered both aesthetics and malaria protection important when deciding whether, when, and how to care for and repair nets. BCC should continue to emphasize the importance of maintaining net integrity for malaria prevention purposes as well as for maintaining aesthetic appeal. Additional research is needed, particularly surrounding washing, drying, daily storage routines, and gender roles in care and repair, in order to understand the complexity of these behaviours, and refine existing or develop new behaviour change communication (BCC) messages for net care and repair.
Highlights
Prolonging net durability has important implications for reducing both malaria transmission and the frequency of net replacement
This study provides an in-depth look at barriers, motivators and attitudes surrounding net care and repair among select households in eastern Uganda
While findings are consistent with other studies regarding the causes and extent of net damage, this study offers some novel insights into the attitudes and social norms surrounding net care and repair in Uganda
Summary
Prolonging net durability has important implications for reducing both malaria transmission and the frequency of net replacement. Protective behaviour, such as net care and repair, offers promise for improving net integrity and durability. Given the potential cost-savings and public health benefit associated with extending the useful life of long-lasting insecticidal nets (LLINs), prevention and mitigation of damage will become ever more critical to ensuring adequate net coverage at the population level. Malaria prevention with long-lasting insecticidal mosquito nets (LLIN) has seen a tremendous scale-up in sub-Saharan Africa in recent years. Prolonging LLIN durability could reduce the frequency of net replacement, potentially resulting in significant cost-savings in procurement and distribution. Keeping nets in good condition is essential to ensuring household use: studies in Ethiopia, Ghana, Kenya, and Senegal found that nets were used regularly when new, but increasingly withdrawn from use as their physical condition deteriorated [7,8,9,10]
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