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Strategies to increase the ownership and use of insecticide-treated bednets to prevent malaria

Additional Info

  • Authors: Lana Augustincic Polec, Jennifer Petkovic, Vivian Andrea Welch, Erin Ueffing, Elizabeth Tanjong Ghogomu, Jordi Pardo Pardo, Mark Grabowsky, Amir Attaran, George A. Wells, Peter Tugwell
  • Published date: 2015-11-02
  • Coordinating group(s): International Development
  • Type of document: Review, Plain language summary
  • Title: Strategies to increase the ownership and use of insecticide-treated bednets to prevent malaria
  • Library Image: Library Image
  • See the full review: https://onlinelibrary.wiley.com/doi/10.4073/csr.2015.17
  • Records available in: English, Spanish
  • English:

    PLAIN LANGUAGE SUMMARY

    Free bednets increase ownership, and education can increase use

    Economic and educational strategies increase people’s ownership and appropriate use of insecticide-treated bednets (ITNs) in developing countries.

    What did the review study?

    Around 40 percent of the world’s population lives in areas affected by malaria, which is a life-threatening parasitic disease. Insecticide-treated bednets (ITNs) effectively prevent malaria. However, barriers to their use have been identified. This Campbell systematic review assesses the effectiveness of economic and educational strategies for ownership and appropriate use of insecticide-treated bednets in developing countries.

    What is the aim of this review?

    This Campbell systematic review assesses the effectiveness of economic, and educational strategies for ownership and appropriate use of insecticide-treated bednets in developing countries. The review also examines whether changes in ITN ownership and use affect malaria-specific morbidity rates. The review summarises findings from 10 studies, nine of which were conducted in rural Africa and one in rural India.

    What studies are included?

    Included studies tested different strategies to increase the ownership and correct use of ITNs among people living in areas affected by malaria. The study design had to have a comparison group, and include participants with permanent residence in malaria areas.

    Eight cluster randomised-controlled studies together with one randomised controlled and one controlled before-after study were included.

    What are the main results in this review?

    Do economic, and educational strategies increase people’s ownership and appropriate use of ITNs?

    Compared to providing ITNS at full market or a subsidized price, giving away ITNs for free increases the number of people owning an ITN. However, the provision of free ITNs increases their use only slightly or not at all.

    Providing education in the appropriate use of ITNs increases the number of people sleeping under bednets compared to a control group which didn’t receive the education.

    Combining these strategies with unspecified incentives does not increase ITN ownership, leading to little or no differences in their appropriate use. Embedding the promotion of ITNs within specific health- or finance-focused marketing messages only leads to small or no differences in bednet ownership and use.

    Do changes in ITN ownership and use affect malaria-specific morbidity rates?

    There is some evidence of improved malaria-specific morbidities among children and adults as a result of increased ITN ownership and use. However, the evidence supporting this finding is of low certainty and should be interpreted with caution.

    Are there any adverse effects from applying economic, educational or marketing strategies to increase the ownership and appropriate use of ITNs in malaria areas of developing countries?

    None of the included studies measured adverse side effects.

    What do the findings in this review mean?

    Providing ITNs for free can increase bednet ownership in malaria areas in developing countries. Combining this economic strategy with education in the appropriate use of ITNs can increase the number of people sleeping under ITNs.

    Further research is needed to compare the relative effectiveness of different ITN delivery and marketing strategies and of different educational approaches to ensure their appropriate use in malaria-infested areas. Future trials should also examine the sustainability of ITN interventions together with the impact of social and demographic factors on ITN ownership and use.

    How up-to-date is this review?

    The review authors searched for studies published until February 2013.

  • Spanish:

    Click on 'Download PDF' on the right to view the plain language summary in Spanish.

Select language:

PLAIN LANGUAGE SUMMARY

Free bednets increase ownership, and education can increase use

Economic and educational strategies increase people’s ownership and appropriate use of insecticide-treated bednets (ITNs) in developing countries.

What did the review study?

Around 40 percent of the world’s population lives in areas affected by malaria, which is a life-threatening parasitic disease. Insecticide-treated bednets (ITNs) effectively prevent malaria. However, barriers to their use have been identified. This Campbell systematic review assesses the effectiveness of economic and educational strategies for ownership and appropriate use of insecticide-treated bednets in developing countries.

What is the aim of this review?

This Campbell systematic review assesses the effectiveness of economic, and educational strategies for ownership and appropriate use of insecticide-treated bednets in developing countries. The review also examines whether changes in ITN ownership and use affect malaria-specific morbidity rates. The review summarises findings from 10 studies, nine of which were conducted in rural Africa and one in rural India.

What studies are included?

Included studies tested different strategies to increase the ownership and correct use of ITNs among people living in areas affected by malaria. The study design had to have a comparison group, and include participants with permanent residence in malaria areas.

Eight cluster randomised-controlled studies together with one randomised controlled and one controlled before-after study were included.

What are the main results in this review?

Do economic, and educational strategies increase people’s ownership and appropriate use of ITNs?

Compared to providing ITNS at full market or a subsidized price, giving away ITNs for free increases the number of people owning an ITN. However, the provision of free ITNs increases their use only slightly or not at all.

Providing education in the appropriate use of ITNs increases the number of people sleeping under bednets compared to a control group which didn’t receive the education.

Combining these strategies with unspecified incentives does not increase ITN ownership, leading to little or no differences in their appropriate use. Embedding the promotion of ITNs within specific health- or finance-focused marketing messages only leads to small or no differences in bednet ownership and use.

Do changes in ITN ownership and use affect malaria-specific morbidity rates?

There is some evidence of improved malaria-specific morbidities among children and adults as a result of increased ITN ownership and use. However, the evidence supporting this finding is of low certainty and should be interpreted with caution.

Are there any adverse effects from applying economic, educational or marketing strategies to increase the ownership and appropriate use of ITNs in malaria areas of developing countries?

None of the included studies measured adverse side effects.

What do the findings in this review mean?

Providing ITNs for free can increase bednet ownership in malaria areas in developing countries. Combining this economic strategy with education in the appropriate use of ITNs can increase the number of people sleeping under ITNs.

Further research is needed to compare the relative effectiveness of different ITN delivery and marketing strategies and of different educational approaches to ensure their appropriate use in malaria-infested areas. Future trials should also examine the sustainability of ITN interventions together with the impact of social and demographic factors on ITN ownership and use.

How up-to-date is this review?

The review authors searched for studies published until February 2013.

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See the full review

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