Impact of a behaviour change communication programme on net durability in eastern Uganda

Abstract

BackgroundThe importance of net durability and the average useful life of a net is increasingly recognized as one of the critical factors that determine how often nets need to be replaced. A study to assess the effect of a net care and repair behaviour change communication (BCC) programme on net durability was conducted in one district in Eastern Uganda with a district in a neighbouring region serving as a comparison. Both districts had received LLINs in September of 2012.MethodsThe intervention was comprised of radio programmes, school and community events. Two-stage cluster sampling household surveys to assess net condition, exposure to BCC messages, and attitudes towards net care and repair were conducted in both districts at baseline (2–3 months post net distribution) and endline (20–21 months post distribution). Net condition was assessed using the proportionate hole index, with nets being classified as either serviceable or too torn.ResultsThe intervention led to an additional 31.2 % increased exposure to net care and repair messages in the intervention district. Respondents in the intervention district had a more positive attitude towards net care and repair (32 % of respondents were classified as having a very positive attitude compared to 10 % in the comparison district), which was positively associated with the number of channels through which messages had been received (P < 0.001). Nets belonging to respondents with a very positive attitude were more often categorized as serviceable (80.2 %) compared to respondents with a poor/average attitude (66.4 %; odds ratio: 2.05, P = 0.028); however, this was only observed for the net brand with the greater physical integrity. Additionally, socio-economic status was a significant predictor of net condition. Although nets in the intervention district had significantly more repairs done per net, the act of repairing alone did not improve net condition.ConclusionsIn conclusion, the evaluation showed that the BCC programme resulted in improved knowledge and attitudes towards care and repair, which impacted positively on net condition. Repairs alone were not sufficient to improve net condition. Additional research on which care behaviours and attitudes are most associated with improved net condition would help BCC planners hone their campaigns.

Knowledge and perception towards net care and repair practice in Ethiopia

“…Authors of this study are not aware of any studies that captured an overall knowledge score on net care and repair; however, the three most common net care approaches mentioned in this study were also identified in studies elsewhere [ 19 , 20 , 25 ]. Careful handling of net and keeping nets out of children’s reach is a common technique used [ 25 ].…”

“…To calculate the overall perception score, the response to eight of the perception statements were added-up and divided by 8 to generate mean perception levels for everyone. Based on the mean score, respondents were further categorized as having negative perceptions when their score was ≤ 0; having positive perception when their score range was between 0.01 and 1.0; and, having very positive perception when their score was between 1.01 and 2.0 [ 19 , 30 ].…”

“…The duration of physical integrity and chemical effectiveness of LLINs are often influenced by factors such as household condition, frequency of washing, type of cooking fuel used, the location of the kitchen inside the house, net repair practice [ 17 , 18 ], and the level of care given to nets in general [ 19 – 21 ]. Increased net care and repair practices could increase the longevity of the net: keeping the net away from children, pests and rodents; rolling up the net when not in use; and washing the net gently were some of the recommended net care approaches [ 19 – 21 ]. In addition, it is also recommended to repair any small hole in the net immediately [ 22 ].…”

What drives the consistent use of long-lasting insecticidal nets over time? A multi-method qualitative study in mid-western Uganda

“…Few attempts to repair the nets were reported although this study did not specifically set out to determine net repair behaviour. Work in another region in Uganda showed that exposure to SBC messages promoting net care and repair resulted in improved knowledge and attitudes towards care and repair, which impacted positively on net condition [ 31 ].…”

Monitoring the durability of the Long-Lasting Insecticidal Nets MAGNet and Royal Sentry in three ecological zones of Mozambique

“…The attitudes measured in this monitoring re ect self-e cacy to care for and repair LLINs, perceived effectiveness of LLIN, and the social norm of net repair. Surprisingly, the practice of folding LLINs up during the day, shown to be very protective in other contexts [17,18], was protective only for LLINs that were 'sometimes' folded up, compared to LLIN that were always or never folded; however, as nearly 70% of nets were never folded and very few (16%) were 'always' folded this may re ect a sample size issue. The type of sleeping place used with the net was not signi cant in the nal model, suggesting that protective behaviours can overcome challenging household environments.…”