Research and Evaluation Division, BRAC, Dhaka, Bangladesh.
PLoS One. 2010 Sep 10;5(9):e12660. doi: 10.1371/journal.pone.0012660.
The use of insecticidal bed nets is found to be an effective public health tool for control of malaria, especially for under-five children and pregnant women. BRAC, an indigenous Bangladeshi non-governmental development organization, started working in the East African state of Uganda in June 2006. As part of its efforts to improve the health and well-being of its participants, BRAC Uganda has been distributing long lasting insecticide-treated bed nets (LLIN) at a subsidized price through health volunteers since February 2008. This study was conducted in March-April 2009 to examine how equitable the programme had been in consistence with BRAC Uganda's pro-poor policy.
METHODOLOGY/PRINCIPAL FINDINGS: Information on possession of LLINs and relevant knowledge on its proper use and maintenance was collected from households either with an under-five child and/or a pregnant woman. The sample included three villages from each of the 10 branch offices where BRAC Uganda's community-based health programme was operating. Data were collected by trained enumerators through face-to-face interviews using a hand-held personal digital assistant (PDA). Findings reveal that the study population had superficial knowledge on malaria and its transmission, including the use and maintenance of LLINs. The households' rate of possession of bed nets (41-59%), and the proportion of under-five children (17-19%) and pregnant women (25-27%) who reported sleeping under an LLIN were not encouraging. Inequity was observed in the number of LLINs possessed by the households, in the knowledge on its use and maintenance, and between the two programme areas.
CONCLUSIONS/SIGNIFICANCE: The BRAC Uganda's LLINs distribution at a subsidized price appeared to be inadequate and inequitable, and BRAC's knowledge dissemination is insufficient for initiating preventive actions such as proper use of LLINs to interrupt malaria transmission. Findings contribute to the on-going debate on LLINs distribution in Africa and make a strong case for its free distribution.
杀虫处理过的蚊帐的使用被发现是控制疟疾的有效公共卫生工具，特别是对于 5 岁以下儿童和孕妇。BRAC 是一家土生土长的孟加拉非政府发展组织，于 2006 年 6 月开始在东非国家乌干达开展工作。作为其努力改善参与者健康和福祉的一部分，BRAC 乌干达自 2008 年 2 月以来通过卫生志愿者以补贴价格分发长效驱虫蚊帐（LLIN）。这项研究于 2009 年 3 月至 4 月进行，以检查该计划在多大程度上符合 BRAC 乌干达的扶贫政策。
方法/主要发现：从有 5 岁以下儿童和/或孕妇的家庭中收集有关拥有 LLIN 的信息以及有关其正确使用和维护的相关知识。该样本包括 BRAC 乌干达社区为基础的卫生方案在 10 个分支办事处中的每一个运作的三个村庄。数据由经过培训的普查员通过使用手持个人数字助理（PDA）的面对面访谈收集。调查结果显示，研究人群对疟疾及其传播、包括 LLIN 的使用和维护，只有肤浅的了解。家庭拥有蚊帐的比例（41-59%）、5 岁以下儿童（17-19%）和孕妇（25-27%）报告睡在 LLIN 下的比例并不令人鼓舞。家庭拥有的 LLIN 数量、对其使用和维护的了解以及两个方案地区之间存在不平等现象。
结论/意义：BRAC 乌干达以补贴价格分发 LLIN 的情况似乎不足且不公平，而 BRAC 的知识传播不足以启动预防性行动，例如正确使用 LLIN 来中断疟疾传播。调查结果为非洲正在进行的 LLIN 分发辩论做出了贡献，并强烈支持免费分发。
