A qualitative study on caretakers%26apos; perceived need of bed-nets after reduced malaria transmission in Zanzibar, Tanzania

作者：Beer Netta^*; Ali Abdullah S; Eskilsson Helena; Jansson Andreas; Abdul Kadir Faiza M; Rotllant Estelrich Guida; Abass Ali K; Wabwire Mangen Fred; Bjorkman Anders; Kallander Karin

来源：BMC Public Health, 2012, 12: 606.

DOI：10.1186/1471-2458-12-606

• Sub-Saharan Africa
• Zanzibar
• Malaria
• Bed-nets
• LLINs
• Health belief model
• Qualitative

Background: The elimination of malaria in Zanzibar is highly dependent on sustained effective coverage of bed-nets to avoid malaria resurgence. The Health Belief Model (HBM) framework was used to explore the perceptions of malaria and bed-net use after a noticeable reduction in malaria incidence. %26lt;br%26gt;Methods: Nineteen in-depth interviews were conducted with female and male caretakers of children under five in North A district, Zanzibar. Deductive content analysis was used to identify meaning units that were condensed, coded and assigned to pre-determined elements of the HBM. %26lt;br%26gt;Results: Awareness of malaria among caretakers was high but the illness was now seen as easily curable and uncommon. In addition to the perceived advantage of providing protection against malaria, bed-nets were also thought to be useful for avoiding mosquito nuisance, especially during the rainy season when the malaria and mosquito burden is high. The discomfort of sleeping under a net during the hot season was the main barrier that interrupted consistent bed-net usage. The main cue to using a bed-net was high mosquito density, and children were prioritized when it came to bed-net usage. Caretakers had high perceived self-efficacy and did not find it difficult to use bed-nets. Indoor Residual Spraying (IRS), which was recognized as an additional means of mosquito prevention, was not identified as an alternative for bed-nets. A barrier to net ownership was the increasingly high cost of bed-nets. %26lt;br%26gt;Conclusions: Despite the reduction in malaria incidence and the resulting low malaria risk perceptions among caretakers, the benefit of bed-nets as the most proficient protection against mosquito bites upholds their use. This, in combination with the perceived high self-efficacy of caretakers, supports bed-net usage, while seasonality interrupts consistent use. High effective coverage of bed-nets could be further improved by reinforcing the benefits of bed-nets, addressing the seasonal heat barrier by using nets with larger mesh sizes and ensuring high bed-net ownership rates through sustainable and affordable delivery mechanisms.

• 出版日期2012-8-3