Abstract
BackgroundNet care and repair behaviours are essential for prolonging the durability of long-lasting insecticidal nets. Increased net durability has implications for protection against malaria as well as cost savings from less frequent net distributions. This study investigated behaviours and motivations for net care and repair behaviours in Senegal with the aim of informing social and behaviour change communication (SBCC) programmes, using the Health Belief Model as a framework.MethodsData were collected from 114 participants in eight regions of Senegal. Participants were eligible for the study if they were at least 18 years old and if their household owned at least one net. These respondents included 56 in-depth interview respondents and eight focus groups with 58 participants. In addition, the qualitative data were supplemented with observational questionnaire data from a total of 556 sleeping spaces. Of these spaces, 394 had an associated net.ResultsReported net care and repair behaviours and motivations varied substantially within this sample. Children and improper handling were seen as major sources of net damage and respondents often tried to prevent damage by storing nets when not in use. Washing was seen as an additional method of care, but practices for washing varied and may have been damaging to nets in some cases. Participants mentioned a sense of pride of having a net in good condition and the uncertainty around when they could expect another net distribution as motivations for net care. Net repair appeared to be a less common behaviour and was limited by the perspective that net degradation was inevitable and that repairs themselves could weaken nets.ConclusionThese findings can be understood using the Health Belief Model framework of perceived severity, perceived susceptibility, perceived barriers, perceived benefits, self-efficacy, and cues to action. This model can guide SBCC messages surrounding net care and repair to promote practices associated with net longevity. Such messages should promote the benefits of intact nets and provide tools for overcoming barriers to care and repair.
Highlights
Net care and repair behaviours are essential for prolonging the durability of long-lasting insecticidal nets
Perceived causes of net damage The reported causes of net damage included daily or improper use of nets, the act of sleeping restlessly or with too many people under a net, the act of hanging a net, negligent behaviour with the net, the actions of children, washing the net, the environment surrounding the net, pests, and wear and tear associated with net repair
‘Improper use’ included pulling the net too tight while hanging it, having too many people sleeping under a net, not properly untucking it and storing it during the day, and other actions such as being too rough with the net, that could result in net damage
Summary
Net care and repair behaviours are essential for prolonging the durability of long-lasting insecticidal nets. Increased net durability has implications for protection against malaria as well as cost savings from less frequent net distributions. Long-lasting insecticidal nets (LLINs) have been proven effective in reducing malaria transmission by preventing contact between the vector and the human host as well as control of the vector itself [1]. The distribution and promotion of LLINs has been integrated into malaria control programmes throughout the world [2]. While net distributions previously targeted specific vulnerable populations (infants and pregnant women), efforts focus on achieving universal coverage, defined at the household level as the use of insecticide-treated nets by all household members, regardless of age or gender [3]. Access to nets has increased but still falls short of universal coverage goals [2]. As soon as nets are distributed, they begin a process of inevitable degradation, developing holes and tears and losing insecticide over time
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