Bed Net Ownership, Use and Perceptions Among Women Seeking Antenatal Care in Kinshasa, Democratic Republic of the Congo (DRC): Opportunities for Improved Maternal and Child Health

This study, published by BMC (BioMed Central) Public Health, describes the knowledge of malaria, attitudes toward malaria and bed net use, levels of ownership and use of bed nets, and factors associated with ownership and use among pregnant women attending antenatal care (ANC) in Kinshasa, Democratic Republic of the Congo (DRC). Women attending their first ANC visit at one maternity clinic in Kinshasa were recruited to take part in the study and were given free insecticide treated bed nets (ITNs). This study reports on the baseline questionnaire, designed to be subsequently followed up at delivery and six months post-delivery to assess ITN use. Authors found that distribution of ITNs through antenatal care clinics may be a highly efficient way to increase access and use of ITNs during a time when women are more vulnerable to malaria, particularly since cost was cited as a significant barrier to owning a net.

Among 351 women interviewed at baseline, 115 (33%) already owned a bed net and 86 (25%) reported to have slept under the bed net the night before the interview. Almost half of the 236 women who did not own a bed net reported cost as a reason for not owning one. When asked about reasons for not sleeping under a net, 87% of women stated not having a net as the reason. Among net owners, over 50% slept under a net every night during the past week and approximately 70% slept under a net every night or almost every night in the past month. The survey found that 68% of all women reported having been diagnosed with malaria in the past year, of which 88% were self-diagnosed.

All participants reported they had heard of malaria. When asked about causes of malaria, 90% of the participants answered mosquitoes. Other common answers were neighbourhood dirt and standing water. While only 25% reported sleeping under a net, over 98% of participants were worried about getting malaria, believed it is important and beneficial to sleep under a mosquito net every night, and believed sleeping under a mosquito net is a good way to protect themselves from malaria. However, less than 30% reported that obtaining a mosquito net in their community was easy. When comparing perceptions of free nets compared to nets that individuals would be required to buy, only 5% of participants felt that nets that one had to buy were more effective in preventing malaria compared to free nets. However, 14% reported they would prefer to use a net that they had bought themselves compared to one given to them for free. Over 80% of the women reported thinking that most people in their neighbourhood would buy other things for their home if they had extra money, rather than buying a mosquito net.

The publication states that married women were more likely to own a net and sleep under a net the night before the interview compared to single women. Women who had completed secondary school education were significantly more likely to own and have slept under a net. Ownership of more durable goods was also significantly associated with net ownership and use. In addition, women who reported thinking that mosquito nets that are bought are better quality than ones given out for free were less likely to own a net; however this association was not statistically significant.

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