Can the collection of expired long-lasting insecticidal nets reduce their coverage and use? Sociocultural aspects related to LLIN life cycle management and use in four districts in Madagascar

Malaria Journal

Research

Alyssa Finlay¹  Marta Wilson-Barthes²  Rindra Rahenintsoa³  Ambinina Ramanantsoa³  Martha Delphine Rahelimalala⁴  Harilala Ranaivoharimina⁵  Joan Muela Ribera⁶  Koen Peeters Grietens⁷  Sarah Hoibak⁸  Avotiana Rakotomanga⁹ 

[1] Division of Parasitic Diseases and Malaria, CDC, Atlanta, USA;Emmanuel International, Zomba, Malawi;Focus Development Agency, Antananarivo, Madagascar;Department of Sociology, University of Antananarivo, Antananarivo, Madagascar;Ministry of Environment, Antananarivo, Madagascar;Ministry of Health, Antananarivo, Madagascar;Partners for Applied Social Sciences PASS International, Tessenderlo, Belgium;Partners for Applied Social Sciences PASS International, Tessenderlo, Belgium;School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan;Medical Anthropology Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;The Global Fund, Geneva, Switzerland;USAID-Deliver Project, Antananarivo, Madagascar;

关键词: Malaria;    Recycling;    Disposal;    Net collection campaign;    Insecticide treated nets (ITNs);    Long lasting insecticide treated nets (LLINs);   

DOI  :  10.1186/s12936-017-2053-z

 received in 2017-06-13, accepted in 2017-10-04,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThere is growing awareness of the likely impact increased numbers of LLINs will have on the environment, if not disposed of or recycled appropriately. As part of a World Health Organization (WHO) and United Nations Environment Programme (UNEP) pilot study to assess environmentally-sound and cost-effective LLIN recycling strategies, the USAID-Deliver Project collected 22,559 used bed nets in Madagascar. A social science study was conducted to provide data on socio-cultural factors related to collection and replacement of LLINs, including impact on primary and other net uses.MethodsEthnographic exploratory research was carried out following the pilot USAID-Deliver net collection and recycling campaign in Betioky, Tsihombe, Fenerive Est and Ambanja districts of Madagascar, triangulating participant observation, interviewing and group discussions. Sampling was theoretical and data analysis was a continuous and iterative process concurrent to data collection. Final analysis was conducted using NVivo10.ResultsThe following themes emerged as contributing to the success of collecting expired LLINs in the community for recycling purposes: (i) net adequacy and preference: characteristic differences between collected and newly distributed nets lead to communities’ reticence to relinquish old nets before confirming new nets were appropriate for intended use. Where newly distributed nets failed to meet local requirements, this was expected to increase alternative uses and decrease household turn over. (ii) Net collection strategies: the net collection campaign brought net use out of the private sphere and into the public arena. Net owners reported feeling ashamed when presenting damaged nets in public for collection, leading to reduced net relinquishment. (iii) Net lifecycle: communities perceived nets as being individually owned and economic value was attributed both to good-condition nets for sleeping and to worn nets for alternative/secondary purposes. Collecting nets at the stage of waste rather than at their prescribed end of life was locally acceptable.ConclusionThe collection of LLINs for recycling/disposal can lead to lower coverage under certain conditions. Collecting used LLINs may be appropriate under the following conditions: (i) nets are collected at the stage of waste; (ii) new nets are in line with community preferences; and (iii) collection strategies have been agreed upon within the community prior to replacement activities. Any collection/recycling of old LLINs should be based on in-depth understanding of the local context and include participatory processes to prevent reduced coverage.

【 授权许可】

CC BY   
© The Author(s) 2017