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. 2023 Mar 27;18(3):e0282209.
doi: 10.1371/journal.pone.0282209. eCollection 2023.

An evaluation of LLIN ownership, access, and use during the Magude project in southern Mozambique

Lucia Fernández Montoya  1   2 , Celso Alafo  1 , Helena Martí-Soler  2 , Mara Máquina  1 , Arlindo Malheia  1 , Charfudin Sacoor  1 , Ana Paula Abílio  3 , Dulcisaria Marrenjo  4 , Nelson Cuamba  4   5 , Beatriz Galatas  1   2 , Pedro Aide  1   3 , Francisco Saúte  1 , Krijn P Paaijmans  1   2   6   7   8
Affiliations

An evaluation of LLIN ownership, access, and use during the Magude project in southern Mozambique

Lucia Fernández Montoya et al. PLoS One. .

Abstract

The Magude Project assessed the feasibly of eliminating malaria in a low transmission setting in southern Mozambique using a package of interventions. This study measured the ownership, access and use of long-lasting insecticide treated nets (LLINs) and inequalities in these indicators across household wealth, size and population subgroups, to understand the protection that LLINs provided during the project. Data were obtained from various household surveys. At least 31% of the nets distributed during the 2014 and 2017 campaigns were lost during the first year post-distribution. Most nets (77.1%) present in the district were Olyset Nets. LLIN access never exceeded 76.3% and use varied seasonally between 40% and 76.4%. LLIN access limited LLIN use during the project, especially during the high transmission season. LLIN ownership, access and use were lower in harder-to-reach localities, in poorer and larger households. Children and women below 30 had poorer access to LLINs than the overall population. Net use was lowest among school-aged children and young adults, especially among young males, and highest in children under 5, pregnant women, in older adults and in households that received indoor residual spraying (IRS). This study revealed that LLIN mass-distribution campaigns alone are not sufficient to achieve the high level of net protection needed during elimination programs and that reviewing the LLIN allocation scheme, top-up distributions and/or community engagement campaigns is needed, also to reduce inequalities in populations' access to LLINs.

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Conflict of interest statement

The authors have read the journal’s policy and have the following competing interests: Abt Associates Inc. provided support in the form of salaries for author NC, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter our adherence to PLOS ONE’s policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.

Figures

Fig 1
Fig 1. Percentage of households in Magude district with at least one LLIN, of households with a least one LLIN for every two people, and of household members with access to a net, segregated by the size of the households.
Fig 2
Fig 2. Percentage of people living in households with at least one LLIN for every two people, segregated by gender and age.
Grey shaded areas represent the locally estimated scatterplot smoothing of the curves.
Fig 3
Fig 3. LLIN use across age and gender in Magude district during the project.
Each line represents data from a single survey or study conducted during the Magude project. Each point is the average bednet use found for the corresponding age in the corresponding study. MDA estimates represent between 77.7% and 89.6% of the population, depending on the MDA survey.
Fig 4
Fig 4. Number of people sleeping under a net according to the number of people per net in the household where the net was found.
See this image and copyright information in PMC

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