Low Utilisation of Insecticide-Treated Nets worrying, behavioral change a need – Expert

Ghana continues to make investments in malaria prevention. This is because she is one of the 11 countries contributing to the global malaria burden.

For instance, out of the 228 million malaria cases recorded across the world, with 405,000 deaths the disease accounted for 42.8 per cent of Out Patient Department (OPD)suspectedcases, 22.2 per cent inpatients admissions and 1.1 per cent inpatient deaths in the country.

One of the nation’s malaria intervention programmes is the distribution of free Insecticide-treated nets (ITNs)and the use of ITNs has been identified as one of the proven cost-effective and efficient components of malaria prevention through vector control approach.

Research has shown that appropriate use of ITN could reduce malaria transmission by about 90 per cent. Sadly, in spite of the several benefits associated with the use of the ITNs, many people after collecting the ITNsfail to sleep in them, hence thwarting the national efforts in combating malaria.

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It is worth stating that Ghana stepped up its malaria campaign, particularly concerning the use of ITNs by embarking on a door-to-door distribution and hang-up exercise to achieve universal ownership and use and this exercise led to an increase in household ownership of ITN from 49 per cent in 2011 to 68 per cent in 2014.

The most recent ITN mass distribution campaign which took place in 2019 pegged the national average at 89 per cent.

The Deputy Director-General of the Ghana Health Service (GHS), Dr Anthony Adofo Ofosu, in a Ghana News Agency (GNA) report of September 26, 2020 headlined: “Media Coalition for Malaria Control and Elimination Launched” expressed worry over the lack of use of ITNs by people who are given the nets.

He is quoted as saying that despite Ghana’s achievement of over 70 per cent of the ITNs coverage, only 50 per cent of people who owned these nets slept in them, leading to widespread exposure to mosquitoes.

Kwame Acquah, a resident of Sarpeiman in the Ga West Municipality told Ghanaian Times that he does not sleep in ITN though he does own one.

For him, even though he lives in an area that has stagnated water, his place ofabode records no mosquito density hence the action.

Kwame Acquah is among the larger audience who have failed to sleep under treated mosquito net though it is considered as one of the potent ways to prevent the silent killer.

Recent studies have shown that the most common reported reasons for non-use of nets included discomfort of nets primarily due to heat and the perception of low mosquito density, outdoor sleeping, fears about insecticide used in treated nets and difficulty hanging a net.

Dr Samuel Oppong, a malaria data advisor,saidone challenge when implementing universal coverage net distribution was ensuring that ITNsare used consistently.

According to him,Information, Education and Communication (IEC) and Behaviour Change Communication (BCC) interventions are often used during or following mass distribution campaigns to encourage the correct hanging and use of ITNs.

Nonetheless, Dr Oppong said continual evidence has shown that despite increasing coverage and ownership of ITNs, net utilization was not tantamountto ownership describing it as worrying.

“This gap between ITN ownership and use has been attributed to an inability or unwillingness to hang and/or use ITNs,or a failure of BCC programmes to convince people to use available nets”.

“Nevertheless, accessibility to ITN by all household members has been found to be the most important determinant of ITN use,”Dr Oppong noted.


Dr Oppong said falling ill or losing a loved one to malaria was the most powerful motivator for consistent ITN noting that men were more likely than women and children to stay outdoors late at night and more likely to sleep outdoors without an ITN.

Speaking on the way forward. Dr Oppong said further behavioural change needed to be encouraged to scale-up malaria prevention and treatment.

By Benedicta Gyimaah Folley

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