In Nigeria, NetWorks is testing novel approaches for distributing nets. NetWorks is also conducting research to understand how climate and behavior can wear out nets. Finally, NetWorks is testing the effect of behavior change communication (BCC) on how households care for their nets and on how long nets last.
Behavior change communication
Field reports increasingly demonstrate that LLINs do not last as long as intended, in large part because the textile becomes too damaged by factors in households such as rodents, children, over-washing, and general handling. The durability of a net, and how long a household considers it useful can be a key determinant of net use and how often nets need to be replaced.
NetWorks is testing whether a BCC campaign can motivate net users to take better care of their nets and repair holes promptly. Extending net life could result in cost savings in net procurement in Nigeria. Additional benefits may include increased incentive for households to use nets daily, and ultimately, sustained protection from malaria. NetWorks and its partner, Center for Communication Programs-Nigeria, is using a combination of household visits, community events, and radio to promote net care and repair. Evaluation results will be available in 2013. Materials from the campaign can be accessed through the online toolkit
High rates of school attendance in Cross Rivers State have created an unparalleled opportunity to reach households with nets.Distributing through schools can be more streamlined than standard campaigns, since many of the necessary elements are in place. Students and their families are already entered into the school registration system, schools have adequate storage facilities, and educators are high motivated to take part in malaria prevention. By distributing nets through both schools and antenatal care, Cross Rivers State can ensure that 75% of households have a net. Between 2012 and 2014, NetWorks will conduct three waves of net distributions in schools in two Local Government Areas (LGAs). The first wave was completed in 2012 and the second and third waves will take place in April 2013 and 2014, respectively.
In Nasarawa and Zamfara states, NetWorks and its partner, Malaria Consortium, are developing systems that help families “pull” nets into their homes when they need them. In these pilots, households seek a net from a community-selected health volunteer, who assesses whether they are eligible for net and provides them with a coupon. Households can use these coupons to obtain a net for free at a health facility (Nasarawa and Zamfara), through a community leader or a place of worship (Zamfara). A full evaluation of the Nasarawa and Cross Rivers distribution efforts will be available in 2014.
NetWorks is also providing technical assistance to the development of net distribution systems throughout much of Nigeria. In 2013, NetWorks trained representatives from 34 of the 36 states and the Federal Capital Territory and members of the federal malaria control program in continuous distribution concepts and the use of a modeling tool called NetCALC. States then drafted state-specific strategies that outlined options for efficient ways to distribute nets and the estimated numbers of nets needed. A report of these strategies will be available in 2013. Case studies and other tools from these pilots can be downloaded from the continuous distribution toolkit .
In addition to the operations research activities described above, NetWorks is also conducting a longitudinal, three-year study that assesses the condition of nets over time in three different climatic zones. The study will compare the proportion of LLINs that are considered to be in good condition between the dry and hot areas of the North (Zamfara), the humid and wet South (Cross Rivers State) and the moderate central area (Nasarawa). The study will provide key information on how long nets last under various field conditions. The second wave of data collection is fielding in March and April 2013, and the final wave, as well as study results, will be available in 2014.
Image from a poster for the net care and repair campaign. Its caption: "Your mosquito net is like
a newborn baby. Handle it with care to make it last and protect your from malaria."
School children holding up their nets after the distribution in Cross Rivers State in 2012.