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Table 1 ITN indicators: advantages and limitations

From: Assessing whether universal coverage with insecticide-treated nets has been achieved: is the right indicator being used?

Indicator Unit of analysis What it measures Advantages Limitations
% HHs owning at least 1 ITN Household Measures what proportion of households has 1 (or more) ITNs Demonstrates the basic ‘reach’ of ITN distribution activities Does not indicate the extent to which individuals have the opportunity to use an ITN—as 1 ITN is nearly always insufficient to enable ITN use by all household members
% HHs owning at least 1 ITN for 2 people Household Measures what proportion of households has enough ITNs to protect all individuals in the household assuming 2 persons use each ITN Correlates with WHO and mass campaigns goals of providing 1 ITN for every 2 people; easy to communicate with a broader audience Underestimates coverage by totally ignoring households that have ITNs to cover a significant portion, but not all, of the individuals in the household
% population that used an ITN the night before the survey People Measures the level of ITN use of all age groups at the time of the survey Provides an exact picture of what proportion of the population is individually protected by an ITN the night before the survey Low ITN use often assumed to be a behavioural problem, but use is highly driven by ITN access, which is not accounted for by this indicator
% population with access to an ITN within the households People Provides an estimate of the proportion of the total population that could have slept under an ITN. Assuming two people share one ITN Accounts for ITNs in all households and precisely counts all individuals that could use an ITN. Can be directly compared with ITN use to identify specific behavioural gaps Can be challenging to conceptualize