Obstacles to Mosquito Net Usage in West Africa: The Advantages of Ethnographic Qualitative Methods for Developing and Assessing Health Interventions

Malaria continues to cause significant morbidity and mortality in the developing world, focusing its devastation on children in sub‐Saharan Africa. To prevent malaria, the World Health Organization recommends access to one insecticide treated bed net (ITN) for every 1.8 at‐risk people (WHO 2014). Despite large‐scale distributions of ITNs, regions like rural Senegal remain hyperendemic (Senegal 2013). More qualitative ethnographic data on how rural populations interact with ITNs is essential to achieving malaria control in sub‐Saharan Africa. This poster presentation has two objectives. First, through images, charts and text, we will discuss the results of a 2012 ethnographic study of mosquito net usage in a rural area in southeast Senegal. Using participant observation and semi‐structured interviews, this community‐based participatory research study found that outdoor sleeping is a major obstacle to ITN use in this population, unlike previous study populations in West Africa (Toe et al. 2009; Iwashita et al. 2010). Furthermore, we found that heads of household did not systematically ask for more nets than required to protect all family members. Interview data and participant observation confirmed concerns for early net damage and the overwashing of nets as additional challenges. Ultimately, our findings demonstrate this community's desire for mosquito nets that will adapt to a variety of sleeping arrangements, as well a need for 54% more nets than suggested by current WHO recommendations, mainly due to ITN durability concerns, exacerbated by overwashing and outdoor sleeping practices. The second objective of this poster presentation is to highlight the benefits of collaboration between medical anthropologists, medical and public health professionals, and local community members for ethnographic qualitative research that reveals household and community‐level challenges to and solutions for global health challenges (Binagwaho et al. 2013; Frieden et al. 2009; Yang et al. 2010). We argue that programs and interventions grounded in this type of in‐depth, community‐based qualitative data have a greater potential to offer sustainable, long‐term solutions to global health challenges, specifically malaria. We hope that conference attendees will visit our poster and engage with us in a discussion about the possibilities for interdisciplinary collaboration for a sustainable future for Africa.