title: Determinants of household demand for bed nets in a rural area of southern Mozambique.
abstract: BACKGROUND
  A key to making insecticide-treated nets (ITNs) a long-term, sustainable solution to the spread of malaria is understanding what drives their purchase and use. Few studies have analysed the determinants of demand for bed nets for malaria prevention at the household level, and in particular, how demand for nets compares with demand for other mosquito prevention methods.
  
  
  METHODS
  This study uses a household survey to assess the determinants of demand for bed nets in an area of endemic malaria transmission in rural, southern Mozambique. The study looks at willingness to pay (WTP) for bed nets, net ownership, usage, and past purchase behaviour, alongside expenditure and frequency of use of alternate methods for malaria prevention.
  
  
  RESULTS
  While overall net ownership in the sample is low, the evidence fails to suggest that poorer households are less likely to own bed nets, when controlling for covariates, nor does the likelihood of receiving a free net depend on socioeconomic status (SES). Formal schooling and market knowledge seem to indicate higher average willingness to pay, while use of alternate methods for malaria prevention, and receipt of Indoor Residual Spraying (IRS) are found to decrease demand for bed nets.
  
  
  CONCLUSIONS
  For long-term sustainability of ITNs to be realized, results suggest that either full or partial subsidies may be necessary in some contexts to encourage households to obtain and use nets. Given the possible substitution effects of combined malaria control interventions, and the danger of not taking into consideration household preferences for malaria prevention, successful malaria control campaigns should invest a portion of their funds towards educating recipients of IRS and users of other preventive methods on the importance of net use even in the absence of mosquitoes.
authors.affiliation: Harvard School of Public Health, Department of Global Health and Population, Boston, MA, USA. claire.chase@harvard.post.edu
authors.forename: Claire
authors.initials: C
authors.lastname: Chase
authors.forename: Elisa
authors.initials: E
authors.lastname: Sicuri
authors.forename: Charfudin
authors.initials: C
authors.lastname: Sacoor
authors.forename: Delino
authors.initials: D
authors.lastname: Nhalungo
authors.forename: Ariel
authors.initials: A
authors.lastname: Nhacolo
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
authors.forename: Clara
authors.initials: C
authors.lastname: Menéndez
mesh_terms: D001512:Bedding and Linens / Q000706:statistics & numerical data*; D005191:Family Characteristics; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods*; D009073:Mozambique; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care; D011482:Protective Devices / Q000706:statistics & numerical data*; D012424:Rural Population