Repeated cross-sectional surveys show mass bed net distribution increases coverage and usage in high-burden households, indicating availability drives protection.
Key Points
To assess changes in insecticide-treated net ownership and usage indicators following a mass distribution campaign across three high-malaria-burden provinces in Papua New Guinea.
Conducted repeated cross-sectional surveys across 12 villages in East Sepik, West Sepik, and Madang provinces 1–4 months before (September–December 2023) and 5–7 months after (May–October 2024) mass distribution.
Sampled 5,671 individuals from 815 randomly selected households using questionnaires, visual net inspections, and individual user-to-net matching.
Evaluated household- and person-level ownership and usage indicators using generalized linear mixed-effects models.
Household ownership of at least one net increased from 94.8% before to 99.4% after distribution (P < 0.001), and mean nets per person rose from 0.55 to 0.64 (P < 0.001).
Universal coverage rose from 60.0% to 69.9% (P = 0.002), with 61.1% of new nets put into active use and 55.5% of older nets lost to follow-up.
Distribution targets were met in two provinces but missed by 38–42% in the third, while usage gains occurred uniformly across all ages and genders without shifting baseline sharing habits.