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Sleeping arrangements and mass distribution of bed nets in six districts in central and northern Mozambique
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OBJECTIVE: Universal coverage with insecticide-treated bed nets
is a cornerstone of modern malaria control. Mozambique has
developed a novel bed net allocation strategy, where the number
of bed nets allocated per household is calculated on the basis
of household composition and assumptions about who sleeps with
whom. We set out to evaluate the performance of the novel
allocation strategy. METHODS: 1,994 households were visited
during household surveys following two universal coverage bed
net distribution campaigns in Sofala and Nampula Provinces in
2010-2013. Each sleeping space was observed for the presence of
a bed net, and the sleeping patterns for each household were
recorded. The observed coverage and efficiency were compared to
a simulated coverage and efficiency had conventional allocation
strategies been used. A composite indicator, the product of
coverage and efficiency, was calculated. Observed sleeping
patterns were compared with the sleeping pattern assumptions.
RESULTS: In households reached by the campaign, 93% (95% CI:
93-94%) of sleeping spaces in Sofala and 84% (82-86%) in Nampula
were covered by campaign bed nets. The achieved efficiency was
high, with 92% (91-93%) of distributed bed nets in Sofala and
93% (91-95%) in Nampula covering a sleeping space. Using the
composite indicator, the novel allocation strategy outperformed
all conventional strategies in Sofala and was tied for best in
Nampula. The sleeping pattern assumptions were completely
satisfied in 66% of households in Sofala and 56% of households
in Nampula. The most common violation of the sleeping pattern
assumptions was that male children 3-10 years of age tended not
to share sleeping spaces with female children 3-10 or 10-16
years of age. CONCLUSIONS: The sleeping pattern assumptions
underlying the novel bed net allocation strategy are generally
valid, and net allocation using these assumptions can achieve
high coverage and compare favorably with conventional allocation
strategies. This article is protected by copyright. All rights
reserved.
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PLUCINSKI, Mateusz M., et al. Sleeping arrangements and mass distribution of bed nets in six districts in central and northern Mozambique. Tropical Medicine & International Health. 2015. Vol. 20, num. 12, pags. 1685-1695. ISSN 1360-2276. [consulted: 14 of August of 2026]. Available at: https://hdl.handle.net/2445/69160