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Ownership and usage of mosquito nets after four years of large-scale free distribution in Papua New Guinea

By Hetzel Manuel W, Gideon Gibson, Lote Namarola, Makita Leo, Siba Peter M and Mueller Ivo


<p>Abstract</p> <p>Background</p> <p>Papua New Guinea (PNG) is a highly malaria endemic country in the South-West Pacific with a population of approximately 6.6 million (2009). In 2004, the country intensified its malaria control activities with support from the Global Fund. With the aim of achieving 80% ownership and usage, a country-wide campaign distributed two million free long-lasting insecticide-treated nets (LLINs).</p> <p>Methods</p> <p>In order to evaluate outcomes of the campaign against programme targets, a country-wide household survey based on stratified multi-stage random sampling was carried out in 17 of the 20 provinces after the campaign in 2008/09. In addition, a before-after assessment was carried out in six purposively selected sentinel sites. A structured questionnaire was administered to the heads of sampled households to elicit net ownership and usage information.</p> <p>Results</p> <p>After the campaign, 64.6% of households owned a LLIN, 80.1% any type of mosquito net. Overall usage by household members amounted to 32.5% for LLINs and 44.3% for nets in general. Amongst children under five years, 39.5% used a LLIN and 51.8% any type of net, whereas 41.3% of pregnant women used a LLIN and 56.1% any net. Accessibility of villages was the key determinant of net ownership, while usage was mainly determined by ownership. Most (99.5%) of the household members who did not sleep under a net did not have access to a (unused) net in their household. In the sentinel sites, LLIN ownership increased from 9.4% to 88.7%, ownership of any net from 52.7% to 94.1%. Usage of LLINs increased from 5.5% to 55.1%, usage of any net from 37.3% to 66.7%. Among children under five years, usage of LLINs and of nets in general increased from 8.2% to 67.0% and from 44.6% to 76.1%, respectively (all p ≤ 0.001).</p> <p>Conclusions</p> <p>While a single round of free distribution of LLINs significantly increased net ownership, an insufficient number of nets coupled with a heterogeneous distribution led to overall low usage rates. Programme targets were missed mainly as a result of the distribution mechanism itself and operational constraints in this very challenging setting.</p

Topics: Malaria, Insecticide-treated nets, Papua New Guinea, Internal medicine, RC31-1245, Medicine, R, DOAJ:Internal medicine, DOAJ:Medicine (General), DOAJ:Health Sciences, Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Publisher: BioMed Central
Year: 2012
DOI identifier: 10.1186/1475-2875-11-192
OAI identifier: oai:doaj.org/article:1192eac97bc644f2a98df1c636a4d43d
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