|Progress in coverage of bed net ownership and use in Burkina Faso 2003–2014: evidence from population-based surveys|
||Sekou Samadoulougou, Morgan Pearcy, Yazoumé Yé, and Fati Kirakoya-Samadoulougou
||Malaria Journal, 16:302; DOI 10.1186/s12936-017-1946-1
Insecticidetreated mosquito nets (ITNs)
||Background: Use of insecticide-treated bed nets (ITNs) is the cornerstone of malaria prevention. In 2010 and 2013,
the Burkina Faso Government launched mass distribution campaigns of ITNs to increase coverage of ownership and
use in the country. This study assessed the progress towards universal bed net coverage in Burkina Faso.
Methods: The authors used data from the Burkina Faso 2003 and 2010 Demographic and Health Surveys (DHS),
the 2006 Multiple Indicator Cluster Surveys (MICS) and the 2014 Malaria Indicator Survey (MIS). For each survey, the
authors computed key malaria prevention indicators in line with recommendations from the Survey and Indicator
Task Force of the Roll Back Malaria Monitoring and Evaluation Reference Group. The trends over a decade was
assessed by calculating percentage point change between 2003 and 2014.
Results: At national level, the proportion of households owning at least one ITN increased substantially from 5.6,
95% CI (4.7, 6.5%) in 2003 to 89.9% (88.5, 91.2%) in 2014, with low heterogeneity between regions. The proportion
of households owning at least one ITN per two people increased significantly from 1.8% (1.4, 2.3%) in 2003 to 49.2%
(47.3, 51.0%) in 2014. ITN use in the general population increased from 2.0% (1.6, 2.3%) in 2003, to 67.0% (65.3, 68.7%)
in 2014. A similar trend was observed among children under the age of five years, increasing from 1.9% (1.5, 2.4%) in
2003 to 75.2% (73.2, 77.3%) in 2014, and among pregnant women, increasing from 3.0% (1.9, 4.2%) in 2003 to 77.1%
(72.9, 81.3%) in 2014. The intra-household ownership gap was 67.0% (61.5, 72.4%) in 2003, but decreased significantly
to 45.3% (43.6, 47.1%) in 2014. The behavioural gap, which was relatively low in 2013 with only 20.0% of people who
had access to an ITN but were not using it, further decreased to 5.9% in 2014.
Conclusion: Burkina Faso made considerable progress in coverage of ITN ownership, access and use between 2003
and 2014, as a result of the two free mass distribution campaigns in 2010 and 2013. However, ITN coverage remains
below the national targets of 100% for ownership and 80% for use. The results of 90% of ownership and 67% of use
confirm that free mass distribution campaigns of ITNs are effective; however, there is room for improvement to reach
and maintain optimal coverage of ITN ownership and use.
Keywords: Bed net, LLIN ownership gap, LLIN use gap, LLIN access gap, Behavioural failure, Malaria