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Community trial of insecticide-treated bed net use promotion in southern Ghana: the Net Use Intervention study

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Translational Behavioral Medicine

ABSTRACT

Insecticide-treated nets (ITNs) reduce malaria transmission and related morbidity and child mortality; however, incorrect and inconsistent use limits their protective factors. This community trial titled the Net Use Intervention study sought to bridge the gap between ITN ownership and use in southern (coastal) Ghana and to determine the best mix of communication tools to affect behavior of ITN owners to consistent use while maintaining optimal internal and external validity. This two-group, non-randomized experiment evaluated a multichannel, multisector intervention process over the course of 8 weeks. A longitudinal cohort was scientifically sampled from six intervention and six control communities for both baseline and posttest surveys. The posttest survey showed no change in knowledge of ITNs in the intervention or control. In terms of use the previous night, there was a strong and statistically significant intervention effect (OR = 1.67; p < .05) within the intervention communities. The overall increase in ITN coverage was approximately one person per night per every two households. The promotion efforts succeeded well beyond the planners’ expectations, not only promoting usage but also dramatically increasing demand for new ITNs.

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Notes

  1. The full protocol for the formative and qualitative research effort is available from the first author.

  2. Adding the absolute values of the decrease in control households and the increase in the intervention households, and dividing by the number of intervention households ([144 + 131]/519 households), yields a proportion of 0.522.

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Acknowledgements

This effort was funded through an award to the Academy for Educational Development as part of the USAID NetMark Project (HRN-AA-00-99-00016-00) from October 1, 1999 to September 30, 2009. The authors would like to thank Elizabeth (Katie) Guth Bothwell, Dr. Noe Crespo, and Beth Wittry for their assistance with this manuscript.

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Authors and Affiliations

  1. Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA

    John P Elder PhD, MPH

  2. UNICEF Swaziland, 1st Floor, Lilunga House, Somhlolo Road, Box 1859, Mbabane, H100, Swaziland

    Augustine Aboagye Botwe MSc

  3. ProMPT Ghana, PMB-CT, 134 Cantonments, Accra, Ghana

    Richmond Ato Selby MD, MPH

  4. Academy for Educational Development, Washington, DC, USA

    Nadra Franklin PhD & Willard D Shaw EdD

Authors
  1. John P Elder PhD, MPH
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  2. Augustine Aboagye Botwe MSc
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  3. Richmond Ato Selby MD, MPH
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  4. Nadra Franklin PhD
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  5. Willard D Shaw EdD
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Corresponding author

Correspondence to John P Elder PhD, MPH.

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Implications

Practice: Promoting protection from malaria must not only distribute adequate numbers of malaria bed nets but also insure that they are being used as intended with sufficient sustainability to protect a population through at least high-risk seasons.

Policy: Policymakers must support these efforts by insuring that sufficient resources are allotted for communication to target groups including forms of mass as well as interpersonal communication.

Research: It is imperative to continue to validate self-report measures of bed net utilization with some form of visual verification.

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Elder, J.P., Botwe, A.A., Selby, R.A. et al. Community trial of insecticide-treated bed net use promotion in southern Ghana: the Net Use Intervention study. Behav. Med. Pract. Policy Res. 1, 341–349 (2011). https://doi.org/10.1007/s13142-011-0032-4

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  • DOI: https://doi.org/10.1007/s13142-011-0032-4

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