Malaria Prevention

Malaria kills hundreds of thousands of people a year, mostly young children. Since its inception, OSI has supported innovative projects seeking to improve malaria prevention. We have funded multiple randomized trials and deployments of innovative technologies in Madagascar and Uganda, leading to peer-reviewed publications and improvements in our understanding of how to use insecticide-treated bednets to best protect people from malaria.

SmartNet Projects

Insecticide-treated bednets are the most widespread way to prevent malaria and they are distributed for free in most malaria endemic countries. Figuring out whether people are using their bednets is hard. Asking about their use is insufficient and misses important variations in use that limit our ability to determine how effective bednets are in preventing malaria.

In 2012, SmartNet was invented by Paul Krezanoski to remotely monitor whether bednets are being used. After multiple feasibility and acceptability trials, the device has been used in field studies. Most recently, OSI has supported the deployment of SmartNet devices in eastern Uganda to determine how effective are bednets in preventing malaria.

Read our SmartNet publications here:

How Are Insecticide-Treated Bednets Used in Ugandan Households? A Comprehensive Characterization of Bednet Adherence Using a Remote Monitor

Objective monitoring of Insecticide-treated bednet use to improve malaria prevention: SmartNet development and validation

And some newer technologies that use machine learning to improve the accuracy of remote bednet monitoring:

Evaluation of an accelerometer-based monitor for detecting bed net use and human entry/exit using a machine learning algorithm

NetComp Projects

The NetComp Project was a malaria prevention and mosquito net distribution project implemented in the central highland region of Madagascar. The NetComp I project in 2004-2005 looked at demand for and use of nets when provided at different price levels.

The effect of price on demand for and use of bednets: evidence from a randomized experiment in Madagascar

From the original project, OSI learned that distributing mosquito nets for free was effective in terms of the number of households subsequently owning nets. However, prompt and correct use of the nets was more difficult to achieve. In order to boost the use of the nets, OSI implemented NetComp II to test the efficacy of providing small financial incentives to households who use mosquito nets correctly.

OSI's team of health educators fanned out to 21 villages to provide health education, perform surveys about malaria knowledge and distribute coupons which were redeemable for free mosquito nets in the local market town. In all, OSI distributed nearly 700 mosquito nets providing protection from malaria to over 2000 people. We found that the use of incentives may be a cost-effective way to rapidly increase the use of nets, especially in vulnerable populations.

Read our publications from NetComp II:

Effect of incentives on insecticide-treated bed net use in sub-Saharan Africa: a cluster randomized trial in Madagascar

Households with young children and use of freely distributed bednets in rural Madagascar

Household malaria knowledge and its association with bednet ownership in settings without large-scale distribution programs: Evidence from rural Madagascar

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