NETMARK FORMATIVE QUALITATIVE RESEARCH IN ZAMBIA
SUMMARY OF FINDINGS

STUDY FINDINGS:

General knowledge about malaria was good. The English term "malaria" was widely recognized and respondents named symptoms of malaria that are generally consistent with biomedical definitions of the illness. Respondents considered malaria to be serious and had good general knowledge of who is most vulnerable to a serious case of the illness. Almost everyone knew that mosquitoes cause malaria, but some thought there were other causes as well.

Mosquitoes were perceived as a major problem, and almost everyone used some kind of mosquito control, whether commercial (coils or aerosols) or traditional (burning things). Respondents had both positive and negative perceptions of all mosquito control methods, but nets were perceived more positively than all other methods.

Most respondents named several benefits of using a net: protection from mosquitoes and other insects; protection from illness, especially malaria; and allowing a good night’s sleep. Net owners were viewed in a positive light, described as "health conscious," "caring," and also "well-to-do" and "high class." The few respondents who cited negative features of nets mentioned discomfort from heat, feeling restricted, and fear of a child becoming trapped.

There was evidence of limited access to nets. Net owners and traders were easy to locate in urban areas, but difficult to find in rural areas [except where ITN (insecticide treated material) projects were operating]. Traders reported difficulty in maintaining stock. In the commercial outlets visited, there was very limited choice in terms of net size, shape, and color. Consumers preferred conical nets for ease of hanging and rectangular nets because they are roomier. They also generally preferred large, white nets. Large-size nets (double and family/king) were also the most commonly purchased size. Net prices varied widely. Traders reported selling nets from about US$3.60 for a single-size net to $12.25 for a double. Consumers reported paying between US$1.80 and $8.90 for double-size nets purchased within the past two years. Net owners sometimes traveled long distances to obtain their nets. Respondents considered nets expensive, and most non-owners said they did not own a net because of the expense. Fathers, either alone or with mothers, made the decision to obtain a net, with fathers tending to buy nets in the commercial sector and mothers obtaining them from projects or clinics.

Nets were not always used year-round; many net-owning households used nets only in the rainy season. Vulnerable groups were not necessarily given priority for sleeping under a net. Only about half of the children under five in net-owning households had slept under a net the prior night. However, all four pregnant women in net-owning households had slept under a net the prior night.

Nets were reportedly washed about every 3-6 months, typically with water and soap, in a basin, separately from clothes. Some nets were dried in the sun and others in the shade. Some owners of treated nets were confused about what to do regarding washing.

The concept of treating nets with insecticide was familiar to most urban respondents and to rural respondents in areas with ITN projects, but only a few net owners had treated their nets. A few of these were dissatisfied, saying that they expected the treated net would kill mosquitoes but that it did not. Traders and consumers generally liked the idea of ITNs, but parents were also concerned about the potential danger of insecticides, especially to children and pregnant women. However, consumers said they would feel better if assured by the Ministry of Health and other credible sources that the treatment product was safe.

Insecticide treatments appeared to be virtually unavailable in the commercial sector, but traders of nets and insect control products were eager to sell them. The insect control market was not specialized; traders who sold nets generally sold other insect control products such as coils and aerosols. They also often sold commodities that were more expensive than nets and were motivated to sell nets because of high demand. Most did not give their customers any advice on malaria prevention or ITNs. Traders said they would be motivated to purchase goods from a specific supplier if they received special discounts or incentives.

Consumers and traders wanted net treatments that thoroughly cover/saturate the net, are easy to use, convenient, fast, have no bad odor, cause no irritation, and are not wasted in the air. Respondents were shown four dipping products (a tablet, granules in a sachet, liquid in a sachet, and liquid in a bottle) and two spraying options (an aerosol and a flit-gun sprayer). Consumers preferred dipping products to the flit-gun sprayer but had no strong preference when dipping products were compared to the aerosol. Among the dipping products, consumers had no real preference but liked those that dissolved easily, came with gloves, and had a plastic bag with a water demarcation line. They worried about products that could spill, were in packaging perceived as insecure, or that could be mistaken for medicine or food. Traders showed some preference for the aerosol spray, tablet, and liquid in bottle form.

Ghana 2004 Household Survey
(PDF, 1,155 KB)