Bed net coverage falls short of target as Tanzania pushes for malaria elimination  

DAR ES SALAAM: A newly published study has found that rural Tanzania is still falling short of its insecticide treated bed net targets, with both ownership and usage remaining below the national benchmark, raising concerns over the country’s ambition to eliminate malaria by 2030.

The study shows that 77.6 per cent of rural residents owned insecticide treated nets, while 77.2 per cent reported sleeping under one the previous night. Both figures fall short of the government target of 80 per cent coverage.

The findings were published last month in the peer reviewed journal Malaria Journal. The study was led by Gervas Chacha of the National Institute for Medical Research, working alongside a multidisciplinary team of researchers from the Ifakara Health Institute, the University of Dar es Salaam, Muhimbili University of Health and Allied Sciences, and the National Malaria Control Programme.

The findings come as Tanzania intensifies efforts to achieve a malaria free society by 2030 through expanded prevention, diagnosis, and treatment programmes.

Researchers observed wide variations across districts, pointing to inequalities in access to malaria prevention tools. Nyasa District in Ruvuma Region recorded the highest bed net ownership at 92.1 per cent and usage at 91.9 per cent, while Kyerwa District in Kagera Region recorded the lowest at 64.4 percent and 64.0 percent respectively.

The researchers warned that Tanzania’s malaria elimination efforts could be undermined if disparities in bed net ownership and use among men, poorer households and less educated communities are not addressed.

Although overall ownership and usage levels were relatively high, both indicators remained below the national target of 80 percent.

“Coverage remained below the national target of 80 percent,” the researchers noted.

The findings point to persistent inequalities in access to and use of insecticide treated nets, which researchers say could slow progress towards malaria elimination unless targeted interventions are strengthened.

Women were significantly more likely than men to own and sleep under insecticide treated nets. The study found that females had 27 percent higher odds of both owning and using a bed net compared to males.

Children under 5 years were among the most protected groups, being nearly twice as likely to own a bed net and more than twice as likely to sleep under one compared to adults.

According to the researchers, this pattern reflects years of targeted distribution through reproductive and child health programmes.

“The higher likelihood of ITN ownership and use in these groups is expected, as women and under 5 children are given free nets through reproductive and child health programmes,” the study said.

Education was identified as another major factor influencing bed net ownership and use.

People with primary education were more likely to own and use bed nets than those with no formal education, while those with secondary education or higher had more than double the likelihood of both owning and using them.

“The higher odds among individuals with primary or higher education may be due to increased likelihood of having learned about malaria prevention in schools and their ability to read and understand malaria prevention messages,” the researchers wrote.

The study also found a strong link between household wealth and bed net coverage. Participants from wealthier households were about 60 percent more likely to own and use insecticide treated nets than those from poorer households.

Researchers said economic barriers continue to limit access to malaria prevention tools among low income families and recommended additional support measures.

“Government should consider increasing ITN subsidies in both private and public distribution channels, including introduction and implementation of special voucher or coupon systems for financially disadvantaged groups,” the study recommended.

The researchers also raised concerns about lower bed net use among men, citing evidence from previous studies suggesting that misconceptions about insecticide treated nets may discourage some men from using them.

They called for targeted awareness campaigns aimed at men, poorer households and less educated communities to help close the remaining coverage gap and strengthen malaria control efforts.

“These findings are critical for refining targeted ITN distribution strategies, improving equity in ITN access as well as strengthening stratified malaria control efforts as Tanzania advances towards malaria elimination,” the researchers said.