Malaria

Insecticide-Treated Net Use

Pregnant women and children sleep under an insecticide-treated net (ITN)

Correct and consistent use of ITNs in malarial areas would reduce all-cause child mortality by 20%.1Insecticide-Treated Bed Nets
CDC 
  This is a habitual behavior that needs to be practiced daily.

Key Points from Global Research

  • In areas with weak distribution systems, making ITNs affordable and regularly available can increase ownership and use.
  • Addressing common community perceptions about the health threat posed by malaria and possible actions to mitigate that threat can ensure sustained use of ITNs.

Behavior Profile Sample: Insecticide-Treated Net Use

A Behavior Profile is a summary analysis of each behavior. This sample draws from global evidence and illustrates the result of using the Create Behavior Profiles Tool to analyze factors, supporting actors and strategies and to ensure logical pathways exist between strategies proposed and factors related to the practice of the behavior. This sample may be used as a starting point or reference for creating country-specific Behavior Profiles.

Create Behavior Profiles

Improve maternal and child survival
Pregnant women and children sleep under an insecticide-treated net (ITN)
Percentage of pregnant women who slept under an insecticide-treated net (ITN) the night before the survey
Percentage of children under age five who slept under an insecticide-treated net (ITN) the night before the survey

Behavior Analysis

Strategy

STEPS

What steps are needed to practice this behavior?
  1. Acquire sufficient ITNs to cover every sleeping space
  2. Hang ITNs appropriately
  3. Retreat, repair, or replace the net as needed

Click on any box
        to see the pathwaysA pathway illustrates how elements in the Behavior Profile are linked. When read from right to left, a pathway highlights how strategies are expected to address the factors to enable adoption of the Accelerator Behavior.  
        of the behavior.

FACTORS

What factors may prevent or support practice of this behavior? These should be analyzed for each country context.
Structural
Accessibility: Populations cannot access ITNs because ITNs are unavailable
Social
Norms: Populations do not sleep under ITNs because malaria is considered normal and unavoidable
Norms: Some populations do not sleep under ITNs when there is insufficient supply as they are not prioritized
Internal
Attitudes and Beliefs: Populations do not sleep under ITNs because they fear possible adverse outcome from insecticides
Attitudes and Beliefs: Populations do not sleep under ITNs because ITNs make them hot or uncomfortable, especially during the hot season
Knowledge: Populations do not acquire or use ITNs because they do not know when or how to do so
Knowledge: Populations do not sleep under ITNs because they do not understand the benefits of using an ITN to prevent malaria

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior?
Institutional
Policymakers: Add local requirements for ITNs (i.e. color, length, shape preference, hanging considerations) to the procurement process
Providers: Counsel caregivers on the use of ITNs in traditional and non-traditional settings
Logistics Personnel: Use available tools (e.g. NetCALC) to ensure sufficient supply of ITNs for mass and continuous distributionr mass and continuous distribution
Managers: Couple distribution of ITN with counseling and ongoing monitoring of correct and consistent use, especially in non-permanent sleeping spaces (such as outside, kitchens, etc.)
Community
Community and Religious Leaders: Advocate for correct and consistent use of ITNs, especially in non-permanent sleeping spaces (e.g. outside, kitchens, etc.)
Household
Family Members: Obtain, hang, and ensure everyone, especially pregnant women and children under five, sleeps under an ITN

POSSIBLE PROGRAM STRATEGIES

How might we focus our efforts based on this analysis?
Enabling Environment
Financing: Monitor and ensure continuous availability of free nets to ensure that the most vulnerable populations have access to ITNs
Policies and Governance: Ensure accountability of health care providers, facilities, and system (e.g. availability of commodities, quality of services, adherence to protocols, etc.) to ensure that targeted population has access to ITNs housing and population needs
Systems, Products and Services
Products and Technology: Procure ITNs based on housing and population needs to ensure that targeted population has access to ITNs
Supply Chain: Procure and distribute adequate ITNs for mass campaigns and routine distribution channels including at antenatal care and EPI visits to ensure that the most vulnerable populations have access to ITNs
Quality Improvement: Prioritize the importance of proper procurement, distribution and counseling with providers during in-service training, supportive supervision pre-service training
Demand and Use
Advocacy : Leverage community data to motivate communities and to create social accountability for ITN use
Communication: Employ appropriate SBCC activities to reinforce caregivers’ knowledge on the importance, efficacy, and benefits of ITN use
Collective Engagement: Engage community members in local ownership of malaria control efforts to ensure community access to ITNs

Global Status of Accelerator Behavior

Percentage of pregnant women who slept under an insecticide-treated net (ITN) the night before the survey

Demographic and Health Survey, Malaria Indicator Survey, The DHS Program Indicator Data API, The Demographic and Health Surveys (DHS) Program

Percentage of children under age five who slept under an insecticide-treated net (ITN) the night before the survey

Malaria Indicator Survey, The DHS Program Indicator Data API, The Demographic and Health Surveys (DHS) Program

Please provide feedback on this page.