Evaluating the impact of individual, social, and environmental factors on bed net use for malaria prevention

The number of malaria cases in the world has been declining over the past decade, in large part due to the use of insecticide treated bed nets. There have been numerous studies evaluating where, when, and why people use nets. Some of the most widely explored factors that influence net use are socio-demographic characteristics including age, gender, and socio-economic status.

In response to the implementation of social and behavior change communication about nets, more recent studies have focused on emotional, cognitive, and social predictors of net use. There is also evidence of climatic factors such as rainfall and temperature affecting net use, and qualitative research has reported decreased net use during the dry season due to perceptions of being too hot under a net as well as increased use during the rains due to increases in perceived nuisance biting.

One of the most important considerations when evaluating net use behavior is whether an individual had access to a net to use in the first place. The objective of this thesis was to evaluate how individual, household, social, and environmental factors impact bed net use, especially among individuals with access to a net in their household. This was done by defining ideational theory in the context of malaria control and modeling how ideation about bed nets can affect net use, in addition to evaluating the role of ideational factors at individual, household, and community levels. Also important was understanding individuals’ propensity to purchase nets, and how particular beliefs and family settings affect this propensity. Finally, this thesis assessed how bed net use was influenced by different ecological factors among individuals with access to a net.