[Understanding the non-use of long-lasting impregnated nets (LLINs) in Niger]

In Niger, malaria is the leading cause of mortality and morbidity among pregnant women and children under 5 years. To decrease these rates, the country initiated a prevention policy of free distribution of long-lasting impregnated nets (LLINs). However, improved physical access to this preventive tool has not led to its regular use in households. A nationally representative quantitative and qualitative survey sought to document the reasons for non-use. The results show that the possession of a LLIN is quite low and confirm the low utilization rate, with significant differences by region. Cultural beliefs are not the main barriers to the use of LLINs in Niger. Knowledge and social, technical, environmental and economic dimensions were all more decisive. These results suggest that while improving awareness and communication is important for changing behavior, it cannot alone remove certain socioeconomic barriers and improve LLIN use.