title: Ownership and usage of insecticide-treated bed nets after free distribution via a voucher system in two provinces of Mozambique.
abstract: BACKGROUND
  Insecticide-treated bed nets (ITNs) are an efficacious intervention for malaria prevention. During a national immunization campaign in Mozambique, vouchers, which were to be redeemed at a later date for free ITNs, were distributed in Manica and Sofala provinces. A survey to evaluate ITN ownership and usage post-campaign was conducted.
  
  
  METHODS
  Four districts in each province and four enumeration areas (EAs) in each district were selected using probability proportional to size. Within each EA, 32 households (HHs) were selected using a simple random sample. Interviews to assess ownership and usage were conducted in each of the selected HHs using personal digital assistants.
  
  
  RESULTS
  Valid interviews were completed for 947 (92.5%) (440 in Manica and 507 in Sofala) of the 1,024 selected HHs. Among participating HHs, 65.0% in Manica and 63.1% in Sofala reported that at least one child under five years of age slept in the house the previous night. HH ownership of at least one bed net of any kind was 20.6% (95% confidence interval [CI]: 7.9%-43.6%) and 35.6% (95% CI: 27.8%-44.3%) pre-campaign; and 55.1% (95% CI: 43.6%-66.1%) and 59.6 (95% CI: 42.4%-74.7%) post-campaign in Manica and Sofala, respectively. Post-campaign HH ownership of at least one ITN was 50.2% (95% CI: 41.8%-58.5%) for both provinces combined. In addition, 60.3% (95% CI: 50.6%-69.2%) of children under five years of age slept under an ITN the previous night.
  
  
  CONCLUSIONS
  This ITN distribution increased bed net ownership and usage rates. Integration of ITN distribution with immunization campaigns presents an opportunity for reaching malaria control targets and should continue to be considered.
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, USA.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Macedo de Oliveira
authors.forename: Adam
authors.initials: A
authors.lastname: Wolkon
authors.forename: Ramesh
authors.initials: R
authors.lastname: Krishnamurthy
authors.forename: Marcy
authors.initials: M
authors.lastname: Erskine
authors.forename: Dana P
authors.initials: DP
authors.lastname: Crenshaw
authors.forename: Jacquelin
authors.initials: J
authors.lastname: Roberts
authors.forename: Francisco
authors.initials: F
authors.lastname: Saúte
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration; D005191:Family Characteristics; D005260:Female; D006078:Government Programs / Q000191:economics; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D057148:Insecticide-Treated Bednets; D007306:Insecticides; D008288:Malaria / Q000517:prevention & control; D008297:Male; D009032:Mosquito Control / Q000191:economics / Q000379:methods*; D057147:Mosquito Nets / Q000191:economics; D009073:Mozambique; D010067:Ownership / Q000191:economics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011482:Protective Devices / Q000191:economics* / Q000706:statistics & numerical data / Q000600:supply & distribution; D040241:Social Marketing
chemical_list: D007306:Insecticides