In this study, we generate high-resolution maps of ITN access, use, and nets-per-capita annually across the 40 highest-burden African countries. Our findings support several existing hypotheses: that use is high among those with access, that nets are discarded more quickly than official policy presumes, and that effectively distributing nets grows more difficult as coverage increases. The primary driving factors behind these findings are most likely strong cultural and social messaging around the importance of net use, low physical net durability, and a mixture of inherent commodity distribution challenges and less-than-optimal net allocation policies, respectively.
These results may be used in a number of ways. By filling in gaps in both space and time between surveys, we produce a complete picture of net coverage over the past 20 years that may be valuable for policy-makers at international, national, and subnational scales. When planning future campaigns, these policy-makers may also find utility in our results highlighting important allocative inefficiencies in net distribution. By estimating net retention times on the national level, we lend support to arguments for supply-side reconsiderations of net durability and quality control. Finally, by making all results and code publicly available, we facilitate information-sharing and use of these results by any public health professional or quantitative researcher who may wish to conduct analyses of their own.
This work was done in collaboration with:
- The Institute for Disease Modelling, Seattle, WA, USA.
- Tropical Health, Baltimore, MD, USA
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Alliance for Malaria Prevention Net Mapping Project
- African Leaders Malaria Alliance