SOCIAL-FACTORS AND CULTURAL-FACTORS AFFECTING RATES OF REGULAR RETREATMENT OF MOSQUITO NETS WITH INSECTICIDE IN BAGAMOYO DISTRICT, TANZANIA

Insecticide-treated mosquito nets have an impact on mortality and morb idity ill young children under controlled conditions. When integrated into larger control programs, there is the danger chat rates of regula r retreatment of the nets with insecticide will drop, greatly limiting their effectiveness as a public health intervention. In Bagamoyo Dist rict, Tanzania, rates of retreatment dropped significantly when paymen t for the insecticide was introduced, A series of neighbourhood (hamle t) meetings were held in all study villages to discuss people's concer ns about the insecticide and ways to increase rates of retreatment. Al though changes were made in the procedure for retreatment, rates of re treatment remained lower than expected and showed marked variation wit hin as well as between villages. We then conducted unstructured key in formant interviews as well as informal discussions in a village with s trong variation between different sectors of the village in rates of r etreatment. While logistical problems were most frequently cited as re asons not to bring nets for retreatment, political and social division s within the community provided a better explanation. This is borne ou t by the low response to rearrangements in logistics which made retrea ting the nets significantly easier for households, and the higher resp onse when changes were made in the channels of communication as well a s the logistic features. It is clearly more difficult for villagers to appreciate the benefits of the insecticide than those of the nets. Gr eat emphasis needs to be placed on the insecticide and its beneficial effects from the outset for any large-scale programme to be sustainabl e.