Catching Mosquitoes, not Fish: Returning Bed Nets to their Proper Use in DRC

 {Photo credit: Overseas Strategic Consulting.}Frank Baraka (left) sews a bed net to use as a fishing net.Photo credit: Overseas Strategic Consulting.

It is 1 p.m. in the village of Kavimvira. The sun is high over Lake Tanganyika, at the foot of the Mitumba Mountain, in scenic Sud Kivu. Frank Baraka has packed the bounty of the morning fishing trip and folded his nets, when his cell phone chimes to signal an incoming text message: “Sleep every night under an Insecticide-Treated Net (ITN), to protect your family from malaria,” he reads out loud, amused, to his fishing companion. 

“This is exactly the message my wife has been pounding at home lately,” Roger Amisi responds. “She says that she heard it at the ETL (Education-Through-Listening) meeting, with Nathalie, you know, the primary school teacher.”

Delaying his lunch, Frank hurries to Nathalie Niéla’s compound to find out about the messages. “Malaria kills children in our community,” Nathalie says. “Sleep under a net every night, to live safe from malaria” she confirms. 

This is the call to action of the Malaria 3+1 Campaign implemented by USAID’s Democratic Republic of Congo-Integrated Health Project (DRC-IHP). This project, led by Management Sciences for Health (MSH) in partnership with the International Rescue Committee (IRC) and Overseas Strategic Consulting, Ltd. (OSC), is collaborating on the malaria campaign in partnership with C-Change, another USAID program. An estimated 140,949 Congolese from 194 villages were exposed to campaign messages on malaria awareness and prevention. In a country where only 5% of pregnant women receive proper preventive malaria therapy, and malaria accounts for nearly 40% of under-five deaths, prevention is a critical priority.

Nathalie is one of 37 women ETL facilitators recently trained in the DRC-IHP’s field office of Uvira. “Thanks to ETL, our husbands no longer use the nets to fish or to protect vegetable gardens,” she affirms proudly. “Nets now serve their purpose of protecting children and pregnant women from mosquito bites.” 

ETL is one pillar of IHP’s Tuendeni-Kumpala Behavior Change Communication strategy which empowers communities to adopt health-seeking behaviors. Tuendeni-Kumpala, which means "moving forward" in Swahili and Tshiluba (two local languages), is an integrated strategy in which ETL facilitators work in synergy with other innovative communication approaches, such as mobile technology, to increase the reach and enhance the behavioral impact of project interventions, such as malaria prevention and use of reproductive health services. 

Through this partnership between USAID, DRC-IHP, and C-Change, a total of 64,584 ITNs were distributed across Bukavu, Kolwezi, Uvira, and Kamina, supporting the effort to boost the number of people using insecticide-treated nets. 

Campaign results from two health zones point to the value of ETL, in terms of actual ITN use. In Kamina (Katanga province), ETL was not yet rolled out when the campaign launched in June 2012. After four months, 82% of the 12,965 households involved in Kamina health zone reported adoption of the preventive behavior. In contrast, 89% of the 9,471 households in Uvira that participated in ETL campaign activities slept every night under an ITN. 

For the project’s communication team, the difference illustrates the powerful effect of ETL. “ETL truly shows results here,” said Donat Ngoyi, DRC-IHP Communication Expert in Uvira. “This approach will, no doubt, help us meet our malaria prevention and treatment goals.” 

The DRC-Integrated Health Project (DRC-IHP), a five-year USAID cooperative agreement, is strengthening the leadership and governance capacity of people working in the health sector to improve the access, availability, and quality of services within 80 target health zones.

Amélie Sow-Dia, PharmD, MHS is a consultant with Overseas Strategic Consulting, a partnering organization on DRC-IHP.