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A qualitative study on caretakers' perceived need of bed-nets after reduced malaria transmission in Zanzibar, Tanzania
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- Beer, Netta (author)
- Karolinska Institutet
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Ali, Abdullah S. (author)
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- Eskilsson, Helena (author)
- Stockholms universitet,Psykologiska institutionen
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- Jansson, Andreas (author)
- Stockholms universitet,Psykologiska institutionen
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Abdul-Kadir, Faiza M. (author)
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Rotllant-Estelrich, Guida (author)
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- Abass, Ali K. (author)
- Karolinska Institutet
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Wabwire-Mangen, Fred (author)
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- Björkman, Anders (author)
- Karolinska Institutet
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Kallander, Karin (author)
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(creator_code:org_t)
- 2012-08-03
- English.
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12, s. 606-
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Abstract
Subject headings
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- Background: The elimination of malaria in Zanzibar is highly dependent on sustained effective coverage of bed-nets to avoid malaria resurgence. The Health Belief Model (HBM) framework was used to explore the perceptions of malaria and bed-net use after a noticeable reduction in malaria incidence. Methods: Nineteen in-depth interviews were conducted with female and male caretakers of children under five in North A district, Zanzibar. Deductive content analysis was used to identify meaning units that were condensed, coded and assigned to pre-determined elements of the HBM. Results: Awareness of malaria among caretakers was high but the illness was now seen as easily curable and uncommon. In addition to the perceived advantage of providing protection against malaria, bed-nets were also thought to be useful for avoiding mosquito nuisance, especially during the rainy season when the malaria and mosquito burden is high. The discomfort of sleeping under a net during the hot season was the main barrier that interrupted consistent bed-net usage. The main cue to using a bed-net was high mosquito density, and children were prioritized when it came to bed-net usage. Caretakers had high perceived self-efficacy and did not find it difficult to use bed-nets. Indoor Residual Spraying (IRS), which was recognized as an additional means of mosquito prevention, was not identified as an alternative for bed-nets. A barrier to net ownership was the increasingly high cost of bed-nets. Conclusions: Despite the reduction in malaria incidence and the resulting low malaria risk perceptions among caretakers, the benefit of bed-nets as the most proficient protection against mosquito bites upholds their use. This, in combination with the perceived high self-efficacy of caretakers, supports bed-net usage, while seasonality interrupts consistent use. High effective coverage of bed-nets could be further improved by reinforcing the benefits of bed-nets, addressing the seasonal heat barrier by using nets with larger mesh sizes and ensuring high bed-net ownership rates through sustainable and affordable delivery mechanisms.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- Sub-Saharan Africa
- Zanzibar
- Malaria
- Bed-nets
- LLINs
- Health belief model
- Qualitative
Publication and Content Type
- ref (subject category)
- art (subject category)
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