Research

Determinants of household demand for bed nets in a rural area of southern Mozambique

Claire Chase¹ , Elisa Sicuri² , Charfudin Sacoor³ , Delino Nhalungo³ , Ariel Nhacolo³ , Pedro L Alonso^2,3 and Clara Menéndez^2,3

¹  Harvard School of Public Health, Department of Global Health and Population, Boston, MA, USA

²  Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Hospital Clínic/Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Rosselló 132, E-08036 Barcelona, Spain

³  Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique

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Malaria Journal 2009, 8:132doi:10.1186/1475-2875-8-132

Published:	15 June 2009

Abstract

Background

A key to making insecticide-treated nets (ITNs) a long-term, sustainable solution to the spread of malaria is understanding what drives their purchase and use. Few studies have analysed the determinants of demand for bed nets for malaria prevention at the household level, and in particular, how demand for nets compares with demand for other mosquito prevention methods.

Methods

This study uses a household survey to assess the determinants of demand for bed nets in an area of endemic malaria transmission in rural, southern Mozambique. The study looks at willingness to pay (WTP) for bed nets, net ownership, usage, and past purchase behaviour, alongside expenditure and frequency of use of alternate methods for malaria prevention.

Results

While overall net ownership in the sample is low, the evidence fails to suggest that poorer households are less likely to own bed nets, when controlling for covariates, nor does the likelihood of receiving a free net depend on socioeconomic status (SES). Formal schooling and market knowledge seem to indicate higher average willingness to pay, while use of alternate methods for malaria prevention, and receipt of Indoor Residual Spraying (IRS) are found to decrease demand for bed nets.

Conclusion

For long-term sustainability of ITNs to be realized, results suggest that either full or partial subsidies may be necessary in some contexts to encourage households to obtain and use nets. Given the possible substitution effects of combined malaria control interventions, and the danger of not taking into consideration household preferences for malaria prevention, successful malaria control campaigns should invest a portion of their funds towards educating recipients of IRS and users of other preventive methods on the importance of net use even in the absence of mosquitoes.