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What drives the consistent use of long-lasting insecticidal nets over time? A multi-method qualitative study in mid-western Uganda

Overview of attention for article published in Malaria Journal, January 2016
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  • Good Attention Score compared to outputs of the same age (71st percentile)

Mentioned by

1 policy source
1 tweeter


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99 Mendeley
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What drives the consistent use of long-lasting insecticidal nets over time? A multi-method qualitative study in mid-western Uganda
Published in
Malaria Journal, January 2016
DOI 10.1186/s12936-016-1101-4
Pubmed ID

Clare E. Strachan, Anthony Nuwa, Denis Muhangi, Albert P. Okui, Michelle E. H. Helinski, James K. Tibenderana


The distribution of long-lasting insecticidal nets (LLINs) through universal coverage campaigns is a widely adopted approach for the prevention of malaria at scale. While post-distribution surveys play a valuable role in determining cross-sectional levels of LLIN retention and use, as well as frequently cited reasons for non-use, few studies have explored the consistency of LLIN use over time, within the expected lifespan of the net, and the factors which may drive this. In this qualitative study, 74 in-depth interviews were conducted with (male) household heads and (female) caregivers of children in LLIN recipient households, as well as community health workers, in Buliisa, Hoima and Kiboga districts in Uganda, 25-29 months following a LLIN mass campaign distribution. A triangulation approach to data analysis was taken, incorporating thematic analysis, most significant change and positive deviance. The factors found to be most influential in encouraging long-term LLIN use were positive experience of net use prior to the distribution, and appreciation or awareness of a range of benefits arising from their use, including protection from malaria as well as importantly, other health, lifestyle, social and economic benefits. Social support from within the community was also identified as an important factor in determining continued use of LLINs. Net use appeared to be more consistent amongst settled urban and rural communities, compared with fishing, pastoralist, refugee and immigrant communities. A multitude of interplaying factors encouraged consistent LLIN use in this setting. Whilst the protection of malaria remains a powerful motivator, social and behaviour change (SBC) strategies should also capitalize on the non-malaria benefits of net use that provide a long-term rationale for consistent use. Where supplies are available, SBC campaigns should promote replacement options, emphasizing ongoing net care and replacement as a household responsibility, thus reducing dependence on free distributions. The triangulation approach to qualitative data analysis enabled increased confidence in the validity of findings and an enhanced contextual understanding of the factors promoting consistent net use in mid-western Uganda. The approach should be considered when designing future studies to explore factors driving net retention and use trends.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 99 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Unknown 98 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 21 21%
Student > Master 18 18%
Student > Ph. D. Student 16 16%
Student > Postgraduate 8 8%
Student > Bachelor 8 8%
Other 18 18%
Unknown 10 10%
Readers by discipline Count As %
Medicine and Dentistry 23 23%
Nursing and Health Professions 16 16%
Agricultural and Biological Sciences 9 9%
Business, Management and Accounting 7 7%
Social Sciences 7 7%
Other 19 19%
Unknown 18 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 June 2019.
All research outputs
of 15,184,339 outputs
Outputs from Malaria Journal
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Outputs of similar age
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Outputs of similar age from Malaria Journal
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Altmetric has tracked 15,184,339 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 4,335 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.8. This one has gotten more attention than average, scoring higher than 62% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 341,588 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them