Evaluation of the coverage and effective use rate of long-lasting insecticidal nets after nation-wide scale up of their distribution in Benin

Background: In Benin, around four million Long-Lasting Insecticide-treated Nets were freely distributed to household to prevent malaria in 2011. In contrast to a previous campaign that targeted only children under 5 years and pregnant women, this distribution campaign was conducted in order to achieve universal coverage. This study presents the results of LLIN coverage and utilization after the distribution campaign. Methods: The study was a cross-sectional household survey which utilized a stratified two-stage cluster sampling design. The strata represented the twelve departments covered by the national distribution campaign in 2011 and included a total of 4,800 households randomly selected in the country. A questionnaire adapted from the standard Malaria Indicator Survey (MIS) Household Questionnaire was used. Data were entered using QPS software and analyzed with R 2.14.1. Results: LLIN ownership was 86.4% (74 - 94). On average, each household received 3 LLINs (2-4). The proportion of households that met the ratio one net for two persons was 77%. The proportions of individuals sleeping under LLINs were high (84.8%). LLIN use among urban residents was 10% lower than in effective users from rural areas (P = 0.00224). Conclusions: The universal distribution campaign conducted in Benin has increased LLIN ownership and use in the community. But additional efforts are need to improve and maintain LLIN coverage.