ITNs Bill Brieger | 28 Aug 2008 03:06 am
Mosquito Net Usage - a fish story
People are creative. People designed and produced a bednet that was impregnated with insecticides in order to prevent malaria. Other people look at these nets and think of their own ‘creative’ ways to deploy them.
A case in point was just published in Malaria Journal. Minikawa and colleagues visited the shorelines of Lake Victoria in Kenya and found that LLINs and non-treated nets were being used to catch and dry fish. They provided pictorial evidence as seen at the right. Specifically at seven villages 283 nets were being used to dry fish and 72 were used for fishing. Most of these nets (84.5%) had been obtained free or at subsidized rates from health centers and NGOs, while the remainder were bought in the market. These nets accounted for 44.4% of the area of drying sheets spread in these villages. Fishing nets and papyrus mats made up the rest of the drying surfaces.
The three most popular reasons for using bednets to dry fish were: fish dry faster on these nets, they don’t stick and not surprisingly, these nets are cheaper.
A total of 220 nets, both LLIN and not, were found in the 111 houses of these seven villages. In contrast to the bednets used for fishing/drying, most (60%) of these had been purchased in the market. The total bednets found in homes were almost enough to meet coverage targets of two per household, and the 145 LLINs were definitely enough for use by the 70 children under five and estimated 20 pregnant women in these villages. But this still does not resolve the ethical issue of providing free or low cost nets to communities only to find them diverted.
Net stories include use for fishing in Zambia, as bridal veils in Zambia and other countries and trapping edible ants in Uganda. These problems arise when LLIN distribution programs focus on the wrong numbers. It is not enough to say how many hundreds of nets have been distributed in a community. The real concern is whether they are used correctly and for the intended purpose. Maybe in the Kenyan case there were too many LLINs given without attention to actual population.
More than likely the bednets for villages along Lake Victoria were distributed without community involvement and follow-up. Local leaders and volunteers should take part in the process so they can remind people about appropriate use, help people install the bednets correctly in their homes and monitor actual bednet use.
on 29 Aug 2008 at 12:22 am 1.David said …
I say put a price tag on them, even if they are still subsidized at some level, and you will start to see the relative value of nets for protection against malaria and nets for fishing. The price point would help to evaluate the value of the nets for all the various purposes, understanding the different uses and benefits would help refine the design of the nets for specific uses. If you build the price point with profit margins for all levels of the distribution system then you can create a market driven distribution system that will grow and last much longer than any regionally targeted free distribution campaign.
on 10 Sep 2008 at 9:22 pm 2.The GiveWell Blog - Exploring how to get real change for your dollar. » Bednet use said …
[…] The Malaria Matters blog recently posted links to numerous examples of nets used for other purposes: Net stories include use for fishing in Zambia, as bridal veils in Zambia and other countries and trapping edible ants in Uganda. These problems arise when LLIN distribution programs focus on the wrong numbers. It is not enough to say how many hundreds of nets have been distributed in a community. The real concern is whether they are used correctly and for the intended purpose. […]
on 25 Oct 2008 at 9:45 am 3.Gil said …
Nets must go into the right community i.e. the community where transmission of malaria is active. Proper method of stratification will help solve the problem of nets going into the wrong community.There are several methods of sratification. The most effective is the one that is simple and able to identify areas with active or ongoing ransmission. Stratification based on historical data is doom to fail.