A Qualitative Study of the Acceptability of Remote Electronic Bednet use Monitoring in Uganda

Authors

Sarah M. Alexander, University of California, San Francisco
Alfred Agaba, Mbarara University of Science and Technology
Jeffrey I. Campbell, Harvard Medical School
Nuriat Nambogo, Consortium for Affordable Medical Technologies
Mallory Johnson, University of California, San Francisco
Kristian R. Olson, Harvard Medical School
Grant Dorsey, University of California, San Francisco
David R. Bangsberg, OHSU-PSU School of Public HealthFollow
multiple additional authors

Published In

BMC Public Health

Document Type

Article

Publication Date

5-19-2022

Subjects

Remote Sensing Monitoring -- Uganda

Abstract

Background

Distribution of long-lasting insecticide treated nets (LLINs) is the most widely used intervention for the prevention of malaria but recall and social desirability biases may lead to challenges in accurately measuring use of bednets. SmartNet is a remote electronic monitor that provides objective measurements of bednet use over weeks at a time. Assessing local acceptability is important when implementing innovative global health technologies such as SmartNet. This study draws on established models such as the Technology Acceptance Model (TAM) and Theoretical Framework of Acceptability (TFA) to assess acceptability of SmartNet in Ugandan households.

Methods

Semi-structured qualitative interviews were conducted at weeks one and six following installation of SmartNet in ten households in Western Uganda. Heads-of-households answered open-ended questions addressing the main acceptability domains of the TFA and TAM models (i.e. perceived ease of use, ethicality, etc.). Responses were digitally recorded, transcribed, coded and analyzed using a thematic analysis approach.

Results

Seven out of ten households interviewed reported no difference in use between SmartNet and a standard LLIN. Households stated the large size, soft fabric, and the efficacy of SmartNet relative to a standard LLIN contributed to perceived usefulness and perceived ease of use. Opportunity costs of the novel monitoring system expressed by households included difficulty washing nets and dislike of blinking lights on the device. Barriers to SmartNet use focused on questions of the ethics of bednet use monitoring, discomfort with technical aspects of the device and a poor understanding of its function amongst others in the community. However, explaining SmartNet to other community members resolved these concerns and often resulted in interest and acceptance among peers.

Conclusion

Objective monitoring of bednet use with SmartNet appears acceptable to these households in Uganda. Use of SmartNet seems to be similar to behaviors around use of standard LLINs. Viewpoints on many aspects of SmartNet were generally favorable. Concerns around ethicality of bednet monitoring are present and indicate the need for continuing community education. The device will continue to be optimized to make it more acceptable to users and to accurately reflect standard LLIN use to improve our understanding of prevention behaviors in malaria endemic settings.

Rights

Copyright (c) 2022 The Authors

This work is licensed under a Creative Commons Attribution 4.0 International License.

Locate the Document

https://doi.org/10.1186/s12889-022-13393-5

DOI

10.1186/s12889-022-13393-5

Persistent Identifier

https://archives.pdx.edu/ds/psu/37811

Citation Details

Alexander, S. M., Agaba, A., Campbell, J. I., Nambogo, N., Camlin, C. S., Johnson, M., ... & Krezanoski, P. J. (2022). A qualitative study of the acceptability of remote electronic bednet use monitoring in Uganda. BMC Public Health, 22(1), 1-10.