[TimorLesteStudies] New article: An exploratory study of treated-bed nets in Timor-Leste: patterns of intended and alternative usage

[Bu Wilson]

       Lover, A.(http://www.malariajournal.com/content/10/1/199/#ins1), Sutton, B., Asy, A..and Wilder-Smith, A. 2011. An exploratory study of treated-bed nets in Timor-Leste: patterns of intended and alternative usage, Malaria Journal, 10:199.





http://www.malariajournal.com/content/10/1/199/abstract
	
Abstract
Background

The Timor-Leste Ministry of Health has recently finalized the National Malaria Control Strategy for 2010-2020. A key component
   of this roadmap is to provide universal national coverage with long-lasting insecticide-treated nets (LLINs) in support of
   achieving the primary goal of reducing both morbidity and mortality from malaria by 30% in the first three years, followed
   by a further reduction of 20% by end of the programme cycle in 2020 [1(http://www.malariajournal.com/content/10/1/199/abstract#B1)]. The strategic plan calls for this target to be supported by a comprehensive information, education and communication (IEC)
   programme; however, there is limited prior research into household and personal usage patterns to assist in the creation of
   targeted, effective, and socio-culturally specific behaviour change materials.


Methods

Nine separate focus group discussions (FGDs) were carried out in Dili, Manatuto, and Covalima districts, Democratic Republic
   of Timor-Leste, in July 2010.



These focus groups primarily explored themes of perceived malaria 
risk, causes of malaria, net usage patterns within families,
   barriers to correct and consistent usage, and the daily experience of
 users (both male and female) in households with at least
   one net. Comprehensive qualitative analysis utilized open source 
analysis software.


Results

The primary determinants of net usage were a widespread perception that nets could or should only be used by pregnant women and young children, and the availability of sufficient sleeping space under a limited number of
   nets within households. Both nuisance biting and disease prevention were commonly cited as primary motivations for usage,
   while seasonality was not a significant factor. Long-term net durability and ease of hanging were seen as key attributes in
   net design preference. Very frequent washing cycles were common, potentially degrading net effectiveness. Finally, extensive
   re-purposing of nets (fishing, protecting crops) was both reported and observed, and may significantly decrease availability
   of nighttime sleeping space for all family members if distributed nets do not remain within the household.


Conclusions

Emphasizing that net usage is acceptable and important for all family
 members regardless of age or gender, and addressing
   the complex behavioural economics of alternative net usages could 
have significant impacts on malaria control efforts in Timor-Leste,
   as the country's programmes make progress towards universal net 
coverage.



--
Dr Bu V.E. Wilson
T: Australia +61  0  407 087 086
T: Timor-Leste + 670 744 0011
E: buvewilson at gmail.com

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