Community Perceptions on Different Delivery Mechanisms for Insecticide-Treated Bed Nets in Rural Burkina Faso

Abstract

Abstract:Background: This study aims to describe the community perceptions regarding an insecticide-treated bed net (ITN) programme in Burkina Faso, where communities were randomised to either ITN social marketing combined with free ITN distribution through antenatal care services (intervention A) or ITN social marketing only (intervention B). Methods:For this descriptive qualitative study data were collected through a total of 20 focus group discussions (FGD), 10 FGD with women and men respectively. FGD were conducted in 8 purposefully selected villages of the study area and in Nouna town. Findings:The ITN free distribution was well known to and highly appreciated in the intervention area A. Awareness of the ITN social marketing distribution was however low in both intervention areas, except in the urban part (Nouna town) of intervention area B. Women were reported to be able to purchase ITNs independent of their husbands. Poverty and frequent unavailability of ITN for purchase were the main barriers for ITN ownership. ITN information was mainly received through personal communication with health workers and through radio messages. Conclusion:While the free ITN distribution was highly appreciated by the population, the social marketing approach alone appeared not be sufficient to reach the goal of high ITN coverage, mainly due to prevailing poverty and the insufficient availability of ITN for purchase.

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“…This hypothesis, however, ought to be confirmed by further qualitative inquiry. This is particularly important because in Burkina Faso, explicit social marketing efforts, including radio transmission, have only accompanied ITN distribution campaigns, not IPTp and ACT programmes (Beiersmann et al, 2008).…”

“…In the case of ITN ownership, the effect can be at least partially explained as a function of an earlier trial on ITN efficacy, which took place in the HDSS villages and which led to the distribution of nearly 3500 ITNs among newborns between 2000 and 2002 (Muller et al, 2006). In our analysis, the legacy of the later trial on ITN distribution mechanisms (Beiersmann et al, 2008;Mueller et al, 2008;Beiersmann et al, 2010;De Allegri et al, 2010) was captured by a different variable (i.e. the one measuring social marketing alone versus social marketing + free distribution through ANC) since the experimental design was applied to the entire District.…”

“…In addition, in half of all CSPS, the same LLINs were distributed free of charge to all pregnant women attending antenatal care (ANC). Both interventions were evaluated within the framework of clusterrandomised community-based trial described in detail elsewhere (Beiersmann et al, 2008;Mueller et al, 2008;Beiersmann et al, 2010;De Allegri et al, 2010). Following the end of the trial, free distribution of LLINs through ANC and child health services was expanded to cover all CSPS in late 2007/early 2008.…”

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“…41 Table 2 shows the variety of study designs used to assess ITN delivery strategies. Of the 18 studies reporting data on ITN ownership among households and ITN use among children under 5, the study design in two (a cluster-randomized controlled trial [22][23][24] and a quasi-experimental study without randomization 21 ) involved comparison areas, and the study design in four involved a temporal comparison. Two of the studies with a temporal comparison evaluated time-limited delivery of fully subsidized ITNs 42,43,47,48 and two analysed continuous delivery of partially subsidized ITNs.…”

“…[22][23][24] One strategy involved subsidized sale, promoted by social marketing, of ITNs to the general population plus free distribution of long-lasting insecticidal nets to pregnant women at antenatal care clinics. The other strategy involved only subsidized sale, promoted by social marketing, of ITNs to the general population through retailers.…”