BRAC Uganda community health promoter Gertrude Kahanda (right) demonstrates the use of a mosquito net to patient Farida Muzafaru
9 May 2012, Kampala - Malaria is the most deadly disease in Uganda. It is responsible for 25-30% of under five deaths in the country, resulting in 70,000-100,000 deaths annually. While children under five are most at risk, only 28% of them sleep under bed nets. Even fewer of these children are sleeping under nets that are properly treated (or retreated) with the necessary insecticides.
BRAC Uganda recently conducted a study to assess the performance of its bed net distribution program. Since February 2008, BRAC Uganda has been distributing long lasting insecticide treated bed nets through its volunteer community health promoters.
One of the key objectives of the study was to determine the possession and usage of insecticidal nets. The study found that about 40% of surveyed households in the Kampala area and 60% surveyed in Eastern districts did not even have insecticidal bed nets. Much graver was that only 14% of household members claimed to have used their bed nets the night before. This finding demonstrated insufficient distribution by NGO's and agencies working in this space. Additionally, there was clearly a lack of comprehensive understanding as to the importance of bed nets and a critical need for greater public education on the issue.
Related to this was a finding that many respondents claimed allergies and aversion to the chemicals used for treating the nets. Public education is needed to curve this belief and reinforce the importance of chemical treatment. Others were washing their nets out too frequently, depleting the active chemicals on the nets and requesting early retreatments. BRAC Uganda does not currently have a program for this, however the results of the study suggests this is necessary.
Another key issue BRAC must contend with is that other agencies are offering bed nets for free. BRAC might consider an arrangement by which it does the same, or perhaps lowers the price it is currently charging. It was shown, however, that users often did not value bed nets if given for free.
Overall, the study was a great success, bringing to light fundamental shortcomings in the program and on-ground realities that were not initially accounted for. Impacting the spread of Malaria is vital and BRAC Uganda will work on the basis of its findings to improve its efforts.