Figures & Tables
Figures
- FIGURE
Illustration of a Rectangular Long-Lasting Insecticidal Net Properly Installed Over a Bed
© 2009 International Federation of Red Cross and Red Crescent Societies.
Tables
Empathize Define Ideate Prototype Test Conduct secondary research
Identify key stakeholders
Engage with them in various ways to understand their circumstances and psychology
Identify insights to refocus and redefine the challenge at hand
Generate ideas and solutions
Create low-fidelity prototypes of ideas for testing
Test prototypes to gain useful information
Use that information to continue refining ideas and solutions
Group Total No. of Participants Region of Ghana Area Population Segment Gender Composition (%) Male Female 1 8 Western Rural Adult (ages 18–58) 62.5 37.5 2 10 Western Rural Student (ages 15–17) 60.0 40.0 3 8 Western Urban Adult (ages 18–58) 50.0 50.0 4 8 Greater Accra Urban Adult (ages 18–58) 50.0 50.0 5 8 Greater Accra Rural Adult (ages 18–58) 50.0 50.0 6 9 Greater Accra Urban Student (ages 15–17) 55.6 44.4 7 9 Ashanti Urban Adult (ages 18–58) 66.7 33.3 8 8 Ashanti Urban Student (ages 15–17) 37.5 62.5 9 10 Ashanti Rural Adult (ages 18–58) 50.0 50.0 Construct Barriers to Use Selected Quotations Examples of Suggested Improvements Convenience Hanging: Tedious to affix or hang because of multiple (at least 4) hanging points
Challenges with finding accessories needed for hanging (e.g., nails, hooks, poles, and strings)
Concerns regarding defacement of bedroom walls by drilling nails or hooks that serve as hanging points
“Bed net installation is stressful.”
—Male Adult, Rural, Ashanti RegionLLIN with minimal hanging points (e.g., single point hang)
Provision of hooks (regular or adhesive) and string with LLIN
Entry and exit: Not easy to enter and exit the LLIN—users have to lift them over their heads each time they enter or exit as well as tuck them under the mattress once inside
“In the middle of the night, when I have to pee, I have to think hard about it, should I wait until morning, or should I go through the stress of getting out of my net?”
—Female Student, Urban, Greater Accra RegionA mechanism that does not require the LLIN to be untucked and lifted overhead for entry and exit (e.g., overlapping flaps or zippered entry in the side of the LLIN)
Access to personal items: When inside the LLIN, users are restricted from accessing nearby personal items that are outside the net (e.g., things on a bedside table, such as bible, phone, eyeglasses, water, condoms)
“As a mother with a baby, I can keep baby pampers in the pocket.”
—Female Adult, Rural, Greater Accra Region
“With a pocket in the bed net, I can put my bible and notebook in there.”
-Male Adult, Rural, Western RegionA pocket inside the LLIN for storage of items that may be needed during the night
Improved entry and exit also addresses this barrier
Comfort Restrictive space: The feeling of being closed-in (e.g., claustrophobic sensation) or lack of space within the LLIN
Particularly an issue for sexually active couples
“I am married and I can't see myself playing games with my wife in a bed net. Even when I was single the bed net was not spacious for me alone. Imagine now that I am married, it won't work unless it is made spacious, so we can feel free in it.”
—Male Adult, Urban, Ashanti RegionRectangular LLINs as they are perceived as more spacious
LLINs in various bed sizes
Heat: Weather conditions are too hot to use an LLIN comfortably
Perception that LLINs increase the heat felt while sleeping
“The weather, the weather, the weather. It is just hot for bed nets! Especially when you use those hard [polyethylene] nets.”
—Male Adult, Rural, Western RegionProvide a small fan to reduce the heat (e.g., Briët et al.14)
Material texture: The material texture of polyethylene LLINs are perceived as both rough and hot
“The [polyethylene net] is hard and can give skin rashes.”
—Male Student in Urban, Ashanti Region
“I didn't like the [polyethylene net] because it feels like rubber, so if you use it, there would be a lot of heat.”
—Female Adult, Urban, Greater AccraUse polyester material for LLINs as it is perceived to be softer and less hot
Insecticide treatment: Adverse reactions to the insecticide in LLIN (e.g., skin irritation and itchiness)
“The real problem is the chemicals in the net. If we use it and it makes us uncomfortable then we stop using it.”
—Female Adult, Urban, Greater AccraImproved messaging about proper care of LLINs before first use (e.g., air out LLIN for at least 24 hours before using)
Aesthetics LLINs detract from bedroom décor by creating a cluttered look in the bedroom
Limited options of LLIN styles and sizes that complement bedroom décor.
“The nets make your room look ugly. We are forced to use it because it protects us against mosquito bites. We need fancy nets, with a variety of colors we can choose from, and ones that are nice to hang so we can do away with all the poles and nails in the walls.”
—Female Adult, Rural, Greater AccraAn LLIN design that is more sleek (e.g., minimal hanging points)
LLINs available in a variety of sizes and colors
Abbreviation: LLIN, long-lasting insecticidal net.
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