Household visits, Greater Accra, August 17-18, 2016
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LocationHousehold characteristicsRegistration and distribution (2016 AMF program)Use of 2016 AMF netsNets from other sourcesNet care and maintenance (AMF or other sources)Misc
Community type
HH size
Children under 5?
Do they still have the coupon?
Who went to the distribution?
Dist pt experience
Received nets from the 2016 AMF distribution?
How many nets did they receive?
How many are hung?
Who slept under AMF nets last night?
How many nets from other sources do they own?
Where and when did they get the nets?
How many nets from other sources are hung?
Who slept under nets from other sources last night?
Are there holes in the nets?
Do they wash nets? How often?
Where do they hang nets after washing?
Do they repair nets if they have holes?
How long do nets last?
Has anyone in the household had malaria?
If they don't use nets, why not?
Do they tuck the edges of the nets under the mattress when in use?
What do they do with unhung nets?
Ga SouthBotianor
New Botianor
Semi-urban112Didn't askUnclearDidn't ask
Other HH member or neighbor
N/AUnclear; we saw a net through a windowUnclear
Unclear: We saw one net hung through a window; we're not sure whether it was from the recent AMF distribution
Unclear: husband said 4, wife said at least 2. Source of nets unclear (some may be from AMF distribution)
Saw 1 hung through a window (unclear if this net was from the AMF distribution)
Unclear: wife said everyone: she&husband, and one in each room for children; husband says he does not usually sleep under a net
Didn't askDidn't askDidn't askSaid yesLong timeDidn't askN/ADidn't askN/A
Wife said that the nets they previously used had harsher chemicals, caused some kind of negative reaction (skin?) but that these ones were better. Spoke to wife and briefly spoke to husband seperately while wife was away.
Ga SouthBotianor
New Botianor
Semi-urban26No, all adults
No: were not at home during registration, no one came back later
N/AN/AN/ANoN/AN/AN/A0N/AN/AN/AN/AN/AN/AN/AN/ADidn't askWould like to have nets, but would not be willing to buy netsN/AN/A
Gated house. They would like to have nets. They would not buy nets. Previous resident was white man/men who used nets.
Ga SouthBotianor
New Botianor
Unclear (there were children around, not clear age)
No, said coupon was not given back. At first I thought she meant her neighbor didn't give it back, but then she said the people at the distribution point didn't give it back.
Mother said someone else went (I think she said her neighbor took the coupons for both of their HHs and brought back nets)
N/AYes40No one0N/AN/AN/AN/A
N/A (haven't started using the nets yet)
N/A (haven't started using the nets yet)
N/A (haven't started using the nets yet)
One eleven-year-old is often sick; it seemed like the mother didn't know how to tell if someone has malaria.
She said she was waiting for help from someone who could bring her nails to hang them
Nothing; she said the person who gave her the nets took them out of their packaging so that they couldn't be resold
We took a picture. She didn't speak English well, though she understood some.
Ga SouthBotianor
New Botianor
We knocked on the gate; no answer
Ga SouthBotianor
New Botianor
Unclear (there were children around, not clear age)
Yes (Grandmother's adult daughter)
No (daughter handles net things)
No; grandmother said people came by to register them (surprised them), but 'never came back to give them nets'. Sounded like she didn't know the date or location of the distribution point. Possibly her daughter did, who was not present, but grandmother said they had no new nets, so that means no one went to the distribution.
Brought with them from Liberia. Not sure when.
Saw 1 hung. Grandmother told us all three were hung.
Yes, several large holes in the net we saw
Didn't askDidn't ask
Yes (we could see that they had sewn up some holes in the old nets, but not all of them)
She indicated that the ones they were using were old, but didn't know how old.
Grandmother says noN/A
She told us she tucks every night, then demonstrated the tucking. She tucked in the corners, but not the middle, and the net didn't reach very far under the corners. It seemed plausible/likely that it wasn't secure. Possibly she tucks better when it's not a demo.
Gated house. The grandmother explained that she is Liberian, and that they have nets that they brought with them. They moved here recently. In January, one of the children said.
Ga SouthBotianor
New Botianor
Unclear (1 child, didn't ask age, seemed like young family)
No, wasn't living here at the time of registration. He said he knows other people around who weren't registered, and asked us how they might get nets.
N/AN/AN/ANoN/AN/AN/A4Bought them around a year ago.2EveryoneDidn't askDidn't askN/ADidn't ask
Didn't ask (still using bought nets after one year)
Didn't askN/ADidn't askNothing
He told us that he comes from (some other community, more central to Ghana, not in Greater Accra). There, malaria is a big problem, and people have demand for nets. When they go to the clinic and ask about nets, they are told there are no nets. (They are willing to buy nets.) We talked with him and said that in that area there had been a problem, some retraining, that nets should be given out ~next week there. The man we talked with didn't know about continuous distribution, that some people could get nets that way. He said he tries to educate people about malaria and nets.
La Dekotopon
3 (young woman's family. Unclear whether young man is in her household)
Didn't ask if she still had it; she said that at the distribution point, the distributor took her half of the coupon, ripped it in half, and gave her back half. She didn't know that there were educational messages on the back.
Yes, young woman we talked to went herself.
It was just down there, at the factory. No line. Took two minutes. Easy. Because not many people from her community went. She said the distributor didn't give her information when she picked up the net.
1 (Young woman said her mother sleeps under a net)
Didn't ask (Young woman said that her mother usually sleeps under a net. The young woman doesn't usually sleep under a net. Young man (maybe from a different household) said he sometimes sleeps under a net.)
Didn't askN/AN/AN/AN/A
They described that as they understood it, you need to wash the net and soak it for a long time. She said she'd seen this on TV. (But said that even then, people experience the allergy.)
Didn't askDidn't askDidn't askDidn't ask
She (and also a young man sitting with her) described an 'allergy' experienced when sleeping under nets: they pointed to their noses and said it was like a cold. The young man also said it made his head (rubbing temples) feel funny to sleep under the net. They also indicated rashes, and said that when you sleep under a net, you don't sleep much. The young woman said that her mother wants her to sleep under the net, but she doesn't. She and the young man agreed that they, and others in their community, don't prefer nets. The young woman also said that she wished the nets had bigger holes (so that there would be more airflow and it would be less hot).
Didn't askDidn't ask
The young man sitting with her who also described his frustration with the insecticide and education messages said that he sleeps under his net sometimes, mostly in the rainy season, when he perceives it to be useful. The young woman said she wishes the nets had bigger holes. The young man said that would be bad because then mosquitoes could get through.
They talked to us at some length about their frustrations with the educational messaging around nets. She feels that the person at the distribution point should have told her everything about nets (all the relevant educational messaging). He proposed that distributors should come door-to-door with nets and talk to each recipient one-on-one to teach them about the nets. (She pointed out that this wasn't feasible, the population of Ghana is too large.) SHe would like more public mass media messaging; he was concerned that community gatherings for messaging would miss people like him who wouldn't think it was worth their time/attention.
La Dekotopon
Unclear (I think we were talking to a few different households)
YesYesDidn't ask
Yes, mother (who we were talking to) went
They tore the packaging before giving them the net.
1: first she said the people at the distribution point were giving out one net per household, no matter how many people were in the household, but then she clarified to 1 net per 2 people
0No one3-4; she was unsure
She described that she had one that was 1-2 years old, but she doesn't use it. It's not torn. She got it from GHS in a clinic. (presumably during pregnancy)
0No one
She said at least one of the nets "wasn't torn"
Didn't askDidn't askDidn't askDidn't ask
Yes they see mosquitoes around and it's a problem; there's an open gutter. When her children play outside she puts them in trousers. She doesn't sit outside in the evening. The youngest children gets sick sometimes. She knows it's malaria because she's taken the child to the hospital and gotten a malaria test.
Mom said that one of the children, who she tried to get to sleep under a net, would just play with the net and not go to sleep, so she removed the net or pushes it aside
Didn't askDidn't ask
She commented that people want and like repellant. She buys repellant. She thinks GHS should give out repellant.
La Dekotopon
2 and baby due soon
Not yet (baby due soon)
NoN/AN/AN/ANoN/AN/ANo one1
Bought recently from a clinic; cost ~20 cedi / $5
0 (planning to hang after baby is born)No oneDidn't askN/AN/AN/AN/A
Yes, husband (who we were talking to) has had malaria. You can't go out in the evening because there are so many mosquitoes. His wife works at the pharmacy, so when he gets malaria, he goes to the pharmacy and gets treatment.
Husband didn't seem to think it was important for him or his pregnant wife to sleep under nets, but his wife and the infant plan to sleep under a net after the baby is born.
N/ADidn't ask
They also had a small (crib) net which they bought at the hospital.
He described that his wife bought one, he doesn't know when, at a clinic. Then someone told her she shouldn't have bought one because they would be given out for free. He's not sure how much it cost, but not more than 20 cedi. He's glad they bought one because no one came by to register them (note: the household seemed not at all inaccessible, was not far from the previous two households that said they'd been registered.) He'd heard about nets being given out, but he'd also heard that they were politically motivated, i.e. being given out to political supporters (it sounded like he'd heard this was going on on a smallish scale, in his community). He said he didn't know who was behind net distributions/couldn't tell, and so thought it was plausible that his house had been passed over for political reasons. When we said the big distribution was by GHS, and that GHS is not political, he seemed to accept/believe that, but pushed back a bit with 'but you vote, people in GHS vote, no one is nonpolitical'.`
La Dekotopon
7-8 (I think, based on notes of who sleeps under nets)
No, didn't live here at the time of registration
N/AN/AN/ANoN/AN/ANo one3
Hospital, 2 years ago. (Didn't ask whether she bought them at the hospital or if they were distributed for free)
3 (she said, we didn't see them)
Everyone; not sure I got this right (b/c of gender mix, but) 3 children under one net, the small boy and the girl under another, and me and my husband under the third. She also said the 1.5y/o sleeps with her.
Didn't askYes, around once a month
Dries a bit in the sun but then dries it in a cool place (shade), because they advise you not to dry too much in the sun
Didn't ask
She said using nets for 3-4 years is OK
Yes. There are many mosquitoes, because of the conditions around here, the banana plants. Yes, children get malaria.
N/ADidn't askN/A
She asked that distributions also distribute repellant. Asked whether people buy repellant and how much it costs, she said that some people can't buy repellant, because of the cost. It costs 2 or 5 cedi.
La Dekotopon
No, just her and her brother (both present, both over 5)
Yes, her mother registered for a bunch of neighbors and themselves
Didn't ask
No, someone brought the nets to them. Not a neighbor, a distributor.
Yes? (given the irregularities here, possible these didn't come from the distribution?)
Mother of girl we talked to (girl we talked to said she doesn't sleep under a net at home, but does when she's at school)
0 (said they didn't own nets before the recent distribution)
N/AN/AN/AN/ADidn't askDidn't askDidn't askDidn't askDidn't askGirl we talked to said "no reason"Didn't askDidn't ask
She seemed a bit wary/ not talkative, and was a minor, so we didn't stay too long.
La Dekotopon
TenashiePharmadexSemi-urban36Didn't askYesDidn't ask
Yes. At first, she sent someone else, with her coupon. But the distributors turned that person away and said that she, as the person whose name was on the coupon, had to come herself. So she went.
No wait.Yes30No one2
She said she has a net (that her mother got from a midwife?) that's over 10 years old and is not torn. (But maybe that's because they don't use the nets.) We didn't ask where the other net came from.
0No one
Said her 10 year old net was not torn
Didn't ask
She thought you were supposed to dry nets in the sun (you aren't)
Didn't ask
Has a 10 year old net (but doesn't seem to use it often)
Didn't ask
Irritation, not sleeping well. The two boys (one was present) sleep together; the one present was fine with sleeping under a net but his brother didn't want to. They disagreed about this. When asked why his brother doesn't want to sleep under the net, the boy said because it's hot.
Didn't askDidn't ask
La Dekotopon
3 (They have 3 people, 3 rooms, and got a net for each.)
Didn't askYesDidn't askYes, she went herself
There was only one other person at the distribution getting nets, so she didn't have to wait. There were 2 distributors. The other person getting nets, who she didn't know, was telling the distributors that she'd had the registers write 1 on the coupon, even though there are 6 people in her household. She received 1 net, because the distributors said there was nothing they could do. The distributor didn't give her educational messages.
Yes30No one
0 (said they didn't own nets before this distribution)
Said there are a lot/ too many mosquitoes. We didn't ask about malaria.
Needs concrete nails to hang the nets in her house. Plans to get nails and hang the nets
N/ADidn't ask
When we told her that it'd be good to hang the nets out to air (but not in the sun) before hanging them, she hadn't heard this before. Other people in the courtyard were enthusiastic about learning this, seemed like one person was saying 'I told you so' to another, as if there had been debate about whether it was good or bad to hang them in the sun. Seemed to specifically be about the sun point.
Ada WestSegeAddodoadziRural112Didn't ask?YesDidn't askSomeone else wentN/AYes6
0. We also couldn't see them because his wife had travelled (and apparently taken the nets with her?)
No one1 (note: we observed more hung)
One from a previous distribution. Also bought cloth and hand-made 'nets'.
2 (one old net, one "sewn" - handmade from buying cloth and sewing a cover for the sleeping area. Neither had insecticide)
Didn't ask. Didn't appear to be from glancing.
Didn't askDidn't askDidn't askDidn't ask
Didn't ask, but he said that everyone has had malaria before. When children get malaria they are sent to the hospital; often it is hard to tell what illness a child has.
Haven't started using new nets because "the old one is still good"
Didn't ask
Didn't ask, but he said that he will be hanging the new nets to replace the old ones soon
He mentioned that his son had taken a bednet to school;
Mentioned that in the past they've had to buy nets, but they don't have the money to buy nets. So sometimes they make their own nets with line.
Said that he likes it when others bring free nets.
Ada WestSegeAddodoadziRural210Didn't askYesDidn't askWifeN/AYes52
Not sure - either children or wife (he didn't sleep under nets himself); yes, children slept under nets
Previous distribution from long ago
Either children or wife; he does not sleep under nets himself
Didn't askDidn't askDidn't askDidn't askDidn't ask
Yes, he gets malaria because he does not sleep under nets
Didn't ask?YesDidn't ask
It looked like there were only 4 sleeping spaces in the household. The man said he didn't sleep under a net because he thought it was just for preganant women and children. I think he said that while he and his wife sleep in the same bed, she is under the net and he is not. He said that they would keep unused new nets until the current ones got old.
Ada WestSegeAddodoadziRural310Didn't askYesDidn't askWife
She experienced no issues and did not have to wait very long to receive her nets
Yes51Didn't ask3
Bought the nets from the market for 20-25 cedi
1Everyone slept under a net.Didn't ask
Yes. The old net had been washed 4 times since received (unclear time period, maybe 3-4 years since last distribution). There was one new AMF net (I think - it was blue) crumpled on some furniture in the house; they told us that it was dirty so they had washed it once.
Didn't askDidn't askDidn't ask
Yes, the children. When the children get malaria they send them to the hospital, where they receive medicine. The hospital has not been out of medicine.
N/AYesDidn't ask
They also told us that they had hung the nets for three days before sleeping under them, so they did not experience any irritation.
Ada WestSegeAddodoadziRural46Didn't askYesDidn't askWifeN/AYes32
Everyone slept under a net last night.
3From a distribution1Didn't askDidn't askDidn't askDidn't askDidn't askDidn't askNobody gets malariaN/ADidn't askJust keep them.
They noted that they are still using an old one because it hasn't yet spoiled. Looked like there were 4 sleeping spaces, 2 in one room, 2 in the other. They commented that distribution should give more than just nets.
Ada WestSege
Luhuour (not randomly selected)
Rural15Didn't askYesDidn't askUnclear
They went on the second day. There were a lot of people. He went on the second day, but didn't have to wait very long.
3 (1 for the elderly man, who is his own HH, and 2 for the HH sized 4)
4She and her children2?None - they took down the old netsN/A
Yes, they get holes, but they repair them
Didn't askDidn't askYes, they sew the nets
Didn't ask. They noted that their nets before were 4 years old, and that they could (or did?) retreat the nets with insecticide.
Yes. They go to the hospital where they are treated with medicine.
N/ADidn't ask
They took down the old nets, but packed them up and keep them, because they can be re-treated with insecticide. Sometimes they throw away old nets, sometimes they use them as a pillow.
One net was crumpled and not obviously over a bed... I think they said it was for someone else or someone else was sleeping under it?
Ada WestSege
Luhuour (not randomly selected)
Rural26Didn't askYesDidn't askShe didDidn't askYes11She did3?
Her mother bought 2 1-2 years ago; she also received one from the antenatal distribution when she went to a clinic
She sleeps with her husband under a net. This net is set up for when she delivers. Then she will sleep with the baby under this net.
Didn't askDidn't askDidn't askDidn't askDidn't askNobody has had malaria yetN/ADidn't askDidn't ask
Our guide noted that the reason the household size and number of nets received doesn't match is probably because some of the people were registered as a different household.
Ada WestSege
Luhuour (not randomly selected)
Yes, older woman's daughter registered
Didn't askHer childrenN/AYes2
0 (she explained that the old ones are still hung, they plan to change them soon)
No one2Distribution four years ago1 (but looked blue like AMF net)Everyone
No, the nets are not spoiled, no tears
Didn't askDidn't askDidn't askDidn't askDidn't ask?N/ADidn't ask
Didn't ask, but she said that they will put the new nets up when the remove the old ones.
No nets were received from routine distribution, and nobody buys nets.
There was one net that was hung that was blue - it looked like an AMF net but I couldn't check the tag.
She complained that they only received 2 nets for a HH of 5.
Ada WestSege
Luhuour (not randomly selected)
Rural45Didn't askYesDidn't ask
Grandmother (who we were talking to) went
Said there wasn't a long line at the distribution point, just a few people
Said that they had hung all the new nets, but for now they had taken everything out of their house (including the nets) because they were replastering the walls
She said that last night everyone slept under a net.
2Distribution four years ago
0 (because everything was taken out of the house for replastering)
Children were using the old nets, but not her (the grandmother). Now she is giving the new nets to the children.
Said the old nets "were not in good condition." Not sure if we asked specifically about holes or not.
Didn't askDidn't askDidn't askDidn't ask
Yes, one child has had malaria. They took the child to the hospital and got medicine.
N/ADidn't askDidn't ask
Unlike at the other houses, we weren't able to check whether the nets were actually hung, since we saw that they were replastering the walls in their house. There was a pregnant woman sitting outside with the grandmother and others. It was unclear whether she was part of the household. She noted that she had a net from ANC and that she was sleeping under it.
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