NETMARK FORMATIVE QUALITATIVE RESEARCH IN NIGERIA
SUMMARY OF FINDINGS

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STUDY FINDINGS:

General knowledge about malaria was good. The English term "malaria" was widely recognized and respondents named symptoms of malaria that are generally consistent with biomedical definitions of the illness. Respondents considered malaria to be serious and had good general knowledge that children (but not necessarily children between 0-5) are vulnerable to a serious case of the illness. Awareness that pregnant women are especially vulnerable appeared lower. Almost everyone knew that mosquitoes cause malaria, but some thought there were other causes as well.

Mosquitoes were perceived as a major problem, and almost everyone, even in rural areas, used some kind of mosquito control (mostly commercial products such as coils or aerosols). Respondents had both positive and negative perceptions of all mosquito control methods, including nets.

Most respondents named several benefits of using a net: protection from mosquitoes and other insects; protection from illness, especially malaria; and allowing a good night’s sleep. Net owners were viewed in a positive light, described as "health conscious," "careful," "people who want a healthy life" and also "clever." Nets were also perceived as a luxury item, reserved for the rich and educated and some people viewed nets as products for use only by infants and students.

Nets were not universally liked. Most non-owners did not want to use a net themselves because they viewed nets as unnecessary or did not like them. Negative perceptions of nets were that they are hot; lack ventilation; are inconvenient to hang, put up and down, or to get in and out of; can feel restrictive; and that children may damage them or become trapped.

Baby net use appears relatively common, as baby-net owners were relatively easy to find¹. However, there is strong evidence that adult-size net availability (i.e., student, single, double, king/family) is very limited. Adult-size net owners were very difficult to find in all areas and only nine were ultimately found to participate in this study. Nets were obtained mostly in open-air markets, where most consumers reported buying their nets. In the commercial outlets visited, there was very limited choice in terms of net size, shape, and color. Consumers preferred conical nets for ease of hanging and rectangular nets because they are roomier. They also generally preferred large, light-colored nets.

Rectangular, large-size nets (doubles and king/family) were the most commonly purchased net shape and sizes. These were also the most common shape and sizes found in trader outlets. Net prices varied widely and traders reported selling nets for less than consumers reported paying for them. Traders reported selling nets from about US$1.05 for a student-size net to $4.40 for a larger net. Consumers reported paying US$4.40 for a single-size net to US$6.65 for a family-size net. Traders in Lagos reported selling their nets for considerably less than did traders in all other areas. Both fathers and mothers made the decision to buy and purchased baby and adult-size nets.

Nets were not always used year-round or in all sleeping situations; some households with adult-size nets reported using them only in the rainy season and never when members slept outdoors. Vulnerable groups were not always given priority for sleeping under a net; some children under five in net-owning households had not slept under a net the prior night.

Nets were reportedly washed anywhere from twice a week to every two months, typically with water and soap (often lye-based), in a basin, separately from clothes and were hung in the sun to dry. Some respondents worried about how washing would affect treated nets.

The concept of treating nets was virtually unknown and no one had ever done so. Traders and consumers generally liked the idea of ITNs, but parents were also concerned about the potential danger of insecticides, especially to children and pregnant women. However, consumers said they would feel better if assured by a range of credible sources that the treatment product was safe. Some respondents also thought the treatments would be ineffective or were unnecessary if other insect control products were used.

Insecticide treatments appeared to be unavailable in the commercial sector; no insecticide treatment traders were found. Although most traders interviewed were interested in selling the treatments, the insect control market is specialized; traders who sold nets generally did not sell other insect control products such as coils and aerosols. As a result, several traders said either that they could not sell nets or that they could not sell insecticide treatments. Traders of insect control products, including nets, often sold more expensive products. Net traders, who generally gave no advice to their customers, were motivated to sell nets because of the potential for profit. These and other traders said that they would be motivated to purchase goods from specific suppliers if they received special discounts and incentives.

Consumers and traders wanted net treatments that thoroughly covered/saturated the net, were easy to use, convenient, fast, required no mixing, had no bad odor, caused no irritation, and were not wasted in the air. Respondents were shown four dipping products (a tablet, granules in a sachet, liquid in a sachet, and liquid in a bottle) and two spraying options (an aerosol and a flit-gun sprayer). Consumers expressed no strong preference for spraying over dipping, while traders overwhelmingly preferred the aerosol spray to any other option. Among the dipping products, traders liked the liquid in a bottle. Consumers appeared to prefer the liquid and granule sachets. Consumers and traders liked dipping products that dissolved easily and came in waterproof bags with water demarcation lines. They had mixed reactions to the inclusion of gloves and worried about products that could spill, that were in packaging perceived as insecure, or that children could easily swallow.

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1. Baby nets are very small, umbrella-shaped nets that stand alone and only fit an infant.