Trials of Improved Practices (TIPs): A Strategy for Making Long-Lasting Nets Last Longer?

Abstract

Abstract. Long-lasting insecticidal net (LLIN) use is a proven malaria prevention method. Mass distribution has greatly expanded LLIN access in sub-Saharan Africa, but a gap remains between LLIN ownership and use. Furthermore, LLINs wear out more quickly than anticipated. This paper suggests a participatory research strategy-trials of improved practices (TIPs)-that could identify locally appropriate approaches to prolonging net life and increasing effective use. We used TIPs to overcome barriers to optimal net use in the Peruvian Amazon. Working with 15 families in three villages, we tested home treatment of cotton nets, use of an alternative netting fabric, and alternative washing and care instructions. TIPs helped confirm feasibility of these interventions. Although our findings are time-and context-specific, TIPs could help improve consistency and effectiveness of current LLIN use and prolong net lifespan in sub-Saharan Africa and elsewhere. This would help maximize the value of shrinking donor resources for malaria.

“It is about how the net looks”: a qualitative study of perceptions and practices related to mosquito net care and repair in two districts in eastern Uganda

“…Programmes should also emphasize that nets are more delicate than clothing and thus require more careful washing. Net distribution and BCC campaigns that demonstrate as well as explain washing technique may be particularly useful [ 13 , 27 , 28 ]. The majority of nets observed hanging in study households were white, the colour of the campaign nets distributed in these two districts.…”

If I do not have enough water, then how could I bring additional water for toilet cleaning?! Addressing water scarcity to promote hygienic use of shared toilets in Dhaka, Bangladesh

“…Using trial of improved practices methodology , we implemented small‐scale pilot interventions to facilitate adequate flushing and regular cleaning of shared toilets. We hired local artists to depict problem scenarios respondents had described regarding shared toilet use, as well as visual instructions for our proposed solutions.…”

Hygiene Practices During Food Preparation in Rural Bangladesh: Opportunities to Improve the Impact of Handwashing Interventions

“…16 Thus, the negotiation of a less ideal behavior may lead to realistic, feasible, and acceptable practice. 51,52 An intervention should encourage people to make soap and water available in the food preparation area; behavior change theory stresses the importance of environmental support to adapt a behavior. 27,53,54 Participants' concern regarding soap cost could be addressed by demonstrating the simplicity and utility of soapy water, the low cost, US$0.038 for a 1.5-L bottle of soapy water that lasted longer than a bar of soap (∼US$0.40) (F. Sultana, F. A. Nizame, N. C. Dutta, L. Unicomb, P. K. Ram, S. P. Luby, P. J. Winch, manuscript in preparation), and convenient alternative found to be as microbiologically effective as soap to reduce pathogens on hands, 55 and to be acceptable elsewhere in Bangladesh.…”