Case Study: Regional Bed Net Care and Repair Tour

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[raw] [cudazi_iconlist] [cudazi_iconlist_icon icon=’paper32.png’ heading=’Download’ text=’Download this google doc for step by step instructions’ link=’’%5D [/cudazi_iconlist] [/raw]

[information_box title=”Background” ]This event builds on the a successful pilot completed World Malaria Day event in 2012. It was scaled up and carried out from September and October of 2012 in 20 different villages in the Kolda region of Senegal. Read about the pilot this initiative is based on. [/information_box]

Conduct Your Own Bed Net Care and Repair Event

[tabs][tab title=”Materials”]

[list style=”check”]

  • 25 sewing needles per event (buy extra to compensate for lost needles)
  • 1 large bar of peanut soap per 6 nets
  • 6 medium sized wash basins
  • 20 meters of thick rope (for hanging the nets)
  • 36 clothes pins
  • Monitor and Evaluating sheets
  • 1 large spool of string (usually enough for 50 nets)
  • Benches and chairs (as available to you)
  • Mats/ground coverings for the repair station
  • (Optional) 1 Radio/Music + Extra Batteries – Not necessary, but definitely improved the atmosphere


[tab title=”Set Up”]

[list style=”check”]

  • Ask the hosting volunteer to invite their village and to pick a location near a water source, lots of shade and some place to hang the rope for drying the nets.
  • 36 clothes pins
  • Clean and sweep the area prior to the event.
  • Fill the wash basins with water and set them up in a circle near the water source. Place a quarter of a bar of soap on each basin.
  • 36 clothes pins
  • Set up several chairs and benches around the perimeter, as is available to you.
  • Run the rope between branches of a tree to be used as lines for the nets to dry. Make sure you have enough lines, otherwise people resort to hanging their nets on fences and in the sun.
  • Cut the string into 1-2meter long pieces to hand out.
  • Cut each bar of soap into four pieces and keep nearby to refill the soap at the wash station.
  • Have drinking water available near the check-in station.


[tab title=”Process”]

Have four stations set up: Check-in, net repair, washing, and drying. When someone arrives at the event, they must first “register” their nets with a volunteer. See below. After the nets are all registered, they are given a needle and a meter of string to repair their net. If they do not know how to sew, a local health worker or volunteer will assist. When the net is fully repaired, the needle should be returned. The participant should then be directed to the washing station. When the nets are all washed and rinsed, the participants should be directed to hang their nets on the line. Have a bag of clothes pins near the drying area. They can also bring their nets home to dry with directions to hang it on a line in the shade. Throughout the event, local music was playing in the background. I think people really enjoyed singing along and dancing while they worked with their nets. About half way through the event, a local health worker held and educational question and answer session for about 20 minutes regarding malaria.[/tab]

Additional Notes

[icon name=’icon-calendar’ color=’Black’ /] Most events were held in the morning- they usually ran from 9 AM to 1 PM.
[icon name=’icon-check’ color=’Black’ /] The educational portion was generally held after everyone had been checked in but had not yet left. This was not a good way to time it- it frequently did not happen. However, when we tried to run it before the participants usually asked us to postpone it until they were ready, but then they left to go make and eat lunch.
[icon name=’icon-road’ color=’Black’ /] I ended up biking with all of the materials to the majority of the participating villages. The soap and wash basins weighed the bike down a lot and also made it quite unstable. If this is your main means of transportation, I would recommend going to villages with well maintained bush paths or near to the road.

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Monitoring and Evaluation

Head of Household’s Name:
If this home-visit being conducted with a community health worker/counterpart, please write his/her name:

Initial Survey (these black boxes slide to hide and reveal the answers)

[toggle title=”Does your household have (enough) useable mosquito nets to sleep under?” collapse=”false” ]

If not, why* (circle)?
Not enough money
Not necessary
Use other means of protection
They are no mosquitoes
Do not like mosquito nets
Not sure

[toggle title=”For how many months/years have you slept under a mosquito net?” collapse=”true” ]
Record months/years

[toggle title=”How many months of the year do members of your family sleep under mosquito nets?” collapse=”true” ]
Record months (0-12)

[toggle title=”If you sleep outside of the bedroom (e.g., in a courtyard), do you and your family sleep under a net?” collapse=”true” ]
Record Yes/No

[toggle title=”Do the members of your household sleep under mosquito nets all-year-round? (circle:Y/N)” collapse=”true” ]
If not, why (circle)*?
Not a lot of mosquitoes
Because of the heat
Do not like mosquito nets

[toggle title=”Ask the interviewee and others present if they will show you how they hang their net(s).” collapse=”true” ]
Number of people able to demonstrate how to correctly hang a net:
Total <5
Total 6-14
Total 15-17
Total 18+

[toggle title=”Total number of nets at household and total number of people sleeping under each net” collapse=”true” ]
Record for each net:
# of people # of people 6-14 who slept under this net last night:
# of people 15-17…
# of people 18+…
# of pregnant women who slept under this net last night
Add totals:
Total <5:
Total 6-14:
Total 15-17:
Total 18+:
Total Pregnant Women:

[toggle title=”Why, last night, did members of your family not sleep under a mosquito net?” collapse=”true” ]
No mosquitoes
Torn net
Net is not effective
Not sure

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PRE-Test Net Repair Questions
    1. What do you do if your net is torn? (Sew or tie the hole)
    2. Why is it important to repair tears or holes in nets? (Mosquitoes do not enter through holes)
    3. Do you know how to sew holes? (knows what to do when handed needle and thread)


Net Net Age 0-2cm 2-5cm 5-10cm 10-15cm 15-20cm 20+cm Repaired Prior?

Comments [Were there concentrations of hole locations? Where? Hole types (puncture vs. tears vs. wear)?]:
[separator full=true /]

PRE-Test Net Washing
  1. How do you wash nets? (more gentle than normal cloths but with non-hot water)
  2. How many times per year do you wash your net? When do you wash your nets? (3-4 times/year, or after rainy, cold, and dry seasons)
  3. What do you wash your net with? (peanut soap)
  4. When was the last time this net was washed (answer in months: if more than a year ago, write 12)?
  5. How and where do you dry your net? (in the shade, not on a fence likely to tear it?)

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Post-Test Net Washing
  1. Understands manner of washing (softly, as to not tear net)
  2. Understands correct frequency of washing (3-4 times/year)
  3. Understands which soap to use for washing nets (peanut soap and not omo/madar/detergents)
  4. Understands nets are to be hung in the shade to dry and not on fences likely to tear the net?

Total number of people trained in net washing/exposed to this training:

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Education Session Questions
  1. What is malaria? Parasitic disease that is in your blood. It is treatable and preventable.
  2. How do you get malaria?/ How is malaria transmitted? Malaria is transmitted ONLY by mosquitoes
  3. How is malaria transmitted? (showing how one person infected with malaria can transmit it to another person)
    a) A person with malaria has the malaria parasite
    b) A mosquito bites the sick person. This mosquito draws the persons blood with the malaria parasites.
    c) Now the mosquito has the malaria parasites.
    d) The mosquito goes and bites a healthy person.
    e) The mosquito deposits the malaria parasites in the body of the healthy person.
    f) Now that person has the malaria parasite.
    g) That person will soon be sick with malaria.
  4. How is malaria known? I.e. how do you know if you have malaria?/How can the malaria parasite be identified?
    You can be tested for malaria for FREE at the health post or health hut with a rapid diagnostic test
  5. If someone is sick with malaria, what will the body do? I.e. what happens to the body when you’re sick with malaria?The symptoms of malaria include:
    Fevers that come in cycles
  6. How does the fever present? The fever can give the illusion that the patient has gotten better
    The fever will periodically abate and return
    Muscle Aches
  7. If you recognize the symptoms of malaria or as soon as a person has a fever, what should you do?
    go quickly to a health facility for an RDT
  8. How is malaria treated?/ What medicines treat malaria?
    If you have the simple form of malaria (palu-simple), the medicine is called ACT (Coratem) and it is FREE
    If you have the complicated form of malaria (palu-grave), the primary medicine is called Quinine and it is not free.
  9. What is the name of malaria medicine?
    Emphasize that the name of the medicine that treats malaria is ACT and NOT paracetamol- Mention that different medicines affect different parts of your body and different diseases. If you want malaria, specifically, to go away, you need to take ACT (assuming its in its simple form) and you need to take ALL OF IT. The medicine is not effective if all of the pills are not taken.
    The complicated form of malaria is treated with many medicines that can total over 20,000 FCFA. The primary medicine is called Quinine. If you go to the health post as soon as you start experiencing symptoms, you will only need to pay the cost of the consultation because it is in its simple form. If you wait, it will become more expensive.
  10. How can a mosquito net save you money?
    a) If a person sleeps under a net, mosquitoes cannot bite her in the net.
    b) If a person if not often bit by mosquitoes, she will not often be sick with malaria.
    c) If a person is not sick with malaria, she will not often spend money on medicine.
    d) If a person is not sick with malaria, she can go to work to earn money.
  11. How is malaria protected against? I.e. how do you prevent malaria?
    Bed Nets (Long Lasting Insecticide Treated Nets/LLINs)
    IPTp- a prophylactic drug given to pregnant women during prenatal consultations (SP)
    Indoor Residual Spraying (insecticide spraying that occurs in several districts)
    Immediate diagnosis/treatment
  12. What should you do with the mosquito net after you get up in the morning?
    roll it up over itself over the bed if the net is over a floor sleeping space, take it down for the day and retie it in the evening
  13. How is a LLIN washed?
    It is washed gently with non-detergent soap
    No more than four times a year
  14. How is a LLIN hung to dry?
    It is hung on a line, in the shade. NOT over a fence or any other place where it could acquire new holes.
  15. Is it ok to wash a LLIN with bleach?/ Is it ok for you to wash a LLIN with bleach?
    It is NOT ok to wash LLINs with bleach or with ‘oumo’
  16. Is it ok for a LLIN to be hung in the sun?/ Is it ok for you to hang a LLIN in the sun?
    It is NOT ok. They should be hung in the shade.
  17. Where should a mosquito net be hung?
    Anywhere a person sleeps, any sleeping space
    Inside and outside
    Over a standing bed, over a floor sleeping space, over an outside stoop/bench
  18. How can a pregnant woman get a mosquito net?
    (where/ how) at her first prenatal visit
    (cost) besides the cost of the consultation ticket, she will be given one net for free
  19. How is a net repaired?
    It is repaired using a needle and thread
  20. Who needs to sleep under a net?
  21. When during the day should a net be hung?
    The nets should be hung in the evening and remain hung until the morning
  22. When during the year should a net be hung?
    It should be hung year-round, due to the fact that you can get malaria at any time of year
  23. Where can malaria medicine be gotten? I.e. Where can you get malaria medicine?
    Malaria medicine is distributed from and sold by pharmacies.
  24. How will a sick person who has gone to the hospital get a cheap net?
    They will receive a ticket during their consultation. They can redeem that ticket with the pharmacist for a 500 FCFA net.

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2 thoughts on “Case Study: Regional Bed Net Care and Repair Tour

  1. Networks is completing a Culture of Net Use study that may shed some light on that. This link is to their initial findings, the second phase (being completed this month) will have a lot more information about net use further along after a distribution. Anecdotal stories from volunteers who have done a lot with net care and repair report that the nets themselves hold up if they are cared for properly. The use of bleach to keep nets white, though, is fairly common. People hang their nets in the sun as well which leads to significant photodegredation. At the moment I’m much less concerned with net quality as I (Michael Toso, Senegal Stomp coordinator) am with the quality of information delivery about use and care at distribution points.

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