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New Study Identifies Key Factors for Mosquito Net Use in Ghana

A recently released study, "Predictors of Mosquito Net Use in Ghana," finds that nets purchased through the private sector instead of provided free of charge are more likely to be used by households in malaria-affected areas. Click here to download the full study.

The peer reviewed study was published in September 2011 in the Malaria Journal and examines the factors associated with mosquito net use in Ghana. The study was co-authored by Carol Baume, previously a senior researcher with AED, and Ana Franka Koh, also a former researcher with AED. Data for the study was collected through the AED NetMark Project, a ten-year (1999-2009), USAID-funded project aimed at reducing the burden of malaria in sub-Saharan Africa by increasing the commercial supply of and public demand for insecticide treated nets.

During the past decade, the malaria control community has been successful in dramatically increasing the number of households that own mosquito nets - particularly insecticide-treated nets (ITNs) and long-lasting insecticide-treated nets (LLINs) - via programmes that made nets available commercially, at subsidized prices, and free of charge to families via mass distributions. However, studies show that as many as half of nets owned by households go unused and there are few systematic studies to understand why a family would not use a net already present in the house.

"Ten years ago it was assumed that if a family got a mosquito net, the net would be used. We have seen, though, that as net ownership has increased, especially with massive efforts to distribute donor LLINs free of charge to families, that many of those nets go unused. It is not unusual to find that thirty to forty percent of nets owned are not used. What a waste! We need to understand why," remarked Baume.

The results of the study also suggest that net use would increase in Ghana if programmes emphasize that malaria is caused only by night-biting mosquitoes, and that nets protect against mosquitoes better than coils and need to be used even if coils are burning; if donated nets are replaced more frequently so that households have nets that are in good condition; and if there were support for the commercial market so that those who can afford to purchase a net and want to choose their own nets can do so.

"The study also showed that certain features of the net such as shape - conical shape was very important in Ethiopia, for instance , or color, as in Ghana - can make it more likely that a net will be used, so choice of features is also important," said Baume. "Now companies are developing LLINs with more user-friendly LLINs designs, so the issue of choice will probably become even more important."

The study underscores the importance of supporting a commercial market while ensuring that those who cannot afford LLINs can get them. AED's NetMark voucher program was notably successful with this model by giving mothers a voucher to obtain a net at retail outlets. For comprehensive information on NetMark, please visit

Posted September 2011

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