Qualitative research and cross-sectional survey methods were used in a stud
y conducted in rural and urban areas of the Greater Accra Region, Ghana, to
explore people's understanding of the cause of malaria and patterns of mos
quito avoidance, in particular bed net ownership and use. The study indicat
ed far higher bed net ownership and use in rural than urban areas, which wa
s related partly to perceived affordability and partly to the different con
texts of and reasons for avoiding mosquitoes. Knowledge of an association b
etween mosquitoes and malaria, the most common cause of illness in both are
as, was related to residence but not to literacy or formal education, and t
his knowledge did not predict bed net use. The paper points to the complexi
ty of social and personal factors implicated in behavioural interventions f
or malaria control, and questions behavioural models that assume a linear r
elationship between knowledge and practice.