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Table 6 Recommendations to improve malaria control measures on Bubaque island

From: A survey of knowledge, attitudes and practices regarding malaria and bed nets on Bubaque Island, Guinea-Bissau

Distribution campaign

Governmental

Ensure a thorough census prior to starting

Ensure every community has adequate access to the campaign

Reach the missing 20% of households through improved sensitisation, social contacts or door-knocking

Ensure sufficient supplies of nets

Provide 1 net per 1.8 people

Attach a dedicated “health educator,” (nurse or trained community health worker) to provide information on malaria, bed nets and IPTp. This could be expanded to other topics

Provide pictorial/written instructions for correct net use at distribution e.g. tucking the net, occupancy, age of expiry

Consider providing net repair kits (and instructions) with each net

Improve the longevity of net labels, for identification of net age. This may require collaboration with manufacturers

Provide regular education programmes in schools, using teachers or healthcare workers

Utilise local radio during and between campaigns. Sensitise communities and provide education on malaria prevention/identification and correct net use/care

Education should highlight the potential human and financial cost of malaria, and misconceptions about net use and safety

Ensure antenatal and immunisation programmes advertise the availability of free bed nets and are well-stocked to do so. Evaluate their distribution

Consider a net exchange programme for broken/expired nets at the hospital

Increase funding for, or access to, transport to hospital

Extend these surveys to other islands for comparison

Take measures to reduce poverty and improve access to items for which bed nets might be substituted e.g. fishing nets