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Behavior Profile Sample: Insecticide-Treated Net Use

A Behavior Profile is a summary analysis of each behavior. This sample draws from global evidence and illustrates the result of using the Create Behavior Profiles Tool to analyze factors, supporting actors and strategies and to ensure logical pathways exist between strategies proposed and factors related to the practice of the behavior. This sample may be used as a starting point or reference for creating Behavior Profiles.

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Health Goal	Improve maternal and child survival
Accelerator Behavior	Pregnant women and children sleep under an insecticide-treated net (ITN) Indicator: Percentage of pregnant women who slept under an insecticide-treated net (ITN) the night before the survey Indicator: Percentage of children under age five who slept under an insecticide-treated net (ITN) the night before the survey

Behavior Analysis	Strategy
STEPS What steps are needed to practice this behavior? Acquire sufficient ITNs to cover every sleeping space Hang ITNs appropriately Retreat, repair, or replace the net as needed Click on any box to see the pathwaysA pathway illustrates how elements in the Behavior Profile are linked. When read from right to left, a pathway highlights how strategies are expected to address the factors to enable adoption of the Accelerator Behavior. of the behavior.	FACTORS What factors may prevent or support practice of this behavior? These should be analyzed for each country context. Structural Accessibility: Stock for universal coverage distribution often differs from true need to cover every sleeping space Accessibility: Populations cannot access ITNs because ITNs are unavailable Accessibility: In areas with weak ITN distribution systems, many cannot afford ITNs Social Norms: Populations do not sleep under ITNs because malaria is considered normal and unavoidable Norms: Some populations do not sleep under ITNs when there is insufficient supply as they are not prioritized Internal Attitudes and Beliefs: Populations do not sleep under ITNs because they fear possible adverse outcome from insecticides Attitudes and Beliefs: Populations do not sleep under ITNs because ITNs make them hot or uncomfortable, especially during the hot season Knowledge: Populations do not acquire or use ITNs because they do not know when or how to do so Knowledge: Populations do not sleep under ITNs because they do not understand the benefits of using an ITN to prevent malaria	SUPPORTING ACTORS AND ACTIONS Who must support the practice of this behavior? Institutional Policymakers: Add local requirements for ITNs (i.e. color, length, shape preference, hanging considerations) to the procurement process Providers: Counsel caregivers on the use of ITNs in traditional and non-traditional settings Logistics Personnel: Use available tools (e.g. NetCALC) to ensure sufficient supply of ITNs for mass and continuous distributionr mass and continuous distribution Managers: Couple distribution of ITN with counseling and ongoing monitoring of correct and consistent use, especially in non-permanent sleeping spaces (such as outside, kitchens, etc.) Community Community and Religious Leaders: Advocate for correct and consistent use of ITNs, especially in non-permanent sleeping spaces (e.g. outside, kitchens, etc.) Household Family Members: Obtain, hang, and ensure everyone, especially pregnant women and children under five, sleeps under an ITN	POSSIBLE PROGRAM STRATEGIES How might we focus our efforts based on this analysis? Enabling Environment Financing: Monitor and ensure continuous availability of free nets to ensure that the most vulnerable populations have access to ITNs Policies and Governance: Ensure accountability of health care providers, facilities, and system (e.g. availability of commodities, quality of services, adherence to protocols, etc.) to ensure that targeted population has access to ITNs housing and population needs Systems, Products and Services Products and Technology: Procure ITNs based on housing and population needs to ensure that targeted population has access to ITNs Supply Chain: Procure and distribute adequate ITNs for mass campaigns and routine distribution channels including at antenatal care and EPI visits to ensure that the most vulnerable populations have access to ITNs Quality Improvement: Prioritize the importance of proper procurement, distribution and counseling with providers during in-service training, supportive supervision pre-service training Demand and Use Advocacy : Leverage community data to motivate communities and to create social accountability for ITN use Communication: Employ appropriate SBCC activities to reinforce caregiversâ€™ knowledge on the importance, efficacy, and benefits of ITN use Collective Engagement: Engage community members in local ownership of malaria control efforts to ensure community access to ITNs

Behavior Analysis

Strategy

STEPS

What steps are needed to practice this behavior?

Acquire sufficient ITNs to cover every sleeping space
Hang ITNs appropriately
Retreat, repair, or replace the net as needed

Click on any box
to see the pathwaysA pathway illustrates how elements in the Behavior Profile are linked. When read from right to left, a pathway highlights how strategies are expected to address the factors to enable adoption of the Accelerator Behavior.
of the behavior.

FACTORS

What factors may prevent or support practice of this behavior? These should be analyzed for each country context.

Structural

Accessibility: Stock for universal coverage distribution often differs from true need to cover every sleeping space

Accessibility: Populations cannot access ITNs because ITNs are unavailable

Accessibility: In areas with weak ITN distribution systems, many cannot afford ITNs

Social

Norms: Populations do not sleep under ITNs because malaria is considered normal and unavoidable

Norms: Some populations do not sleep under ITNs when there is insufficient supply as they are not prioritized

Internal

Attitudes and Beliefs: Populations do not sleep under ITNs because they fear possible adverse outcome from insecticides

Attitudes and Beliefs: Populations do not sleep under ITNs because ITNs make them hot or uncomfortable, especially during the hot season

Knowledge: Populations do not acquire or use ITNs because they do not know when or how to do so

Knowledge: Populations do not sleep under ITNs because they do not understand the benefits of using an ITN to prevent malaria

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior?

Institutional

Policymakers: Add local requirements for ITNs (i.e. color, length, shape preference, hanging considerations) to the procurement process

Providers: Counsel caregivers on the use of ITNs in traditional and non-traditional settings

Logistics Personnel: Use available tools (e.g. NetCALC) to ensure sufficient supply of ITNs for mass and continuous distributionr mass and continuous distribution

Managers: Couple distribution of ITN with counseling and ongoing monitoring of correct and consistent use, especially in non-permanent sleeping spaces (such as outside, kitchens, etc.)

Community

Community and Religious Leaders: Advocate for correct and consistent use of ITNs, especially in non-permanent sleeping spaces (e.g. outside, kitchens, etc.)

Household

Family Members: Obtain, hang, and ensure everyone, especially pregnant women and children under five, sleeps under an ITN

POSSIBLE PROGRAM STRATEGIES

How might we focus our efforts based on this analysis?

Enabling Environment

Financing: Monitor and ensure continuous availability of free nets to ensure that the most vulnerable populations have access to ITNs

Policies and Governance: Ensure accountability of health care providers, facilities, and system (e.g. availability of commodities, quality of services, adherence to protocols, etc.) to ensure that targeted population has access to ITNs housing and population needs

Systems, Products and Services

Products and Technology: Procure ITNs based on housing and population needs to ensure that targeted population has access to ITNs

Supply Chain: Procure and distribute adequate ITNs for mass campaigns and routine distribution channels including at antenatal care and EPI visits to ensure that the most vulnerable populations have access to ITNs

Quality Improvement: Prioritize the importance of proper procurement, distribution and counseling with providers during in-service training, supportive supervision pre-service training

Demand and Use

Advocacy : Leverage community data to motivate communities and to create social accountability for ITN use

Communication: Employ appropriate SBCC activities to reinforce caregiversâ€™ knowledge on the importance, efficacy, and benefits of ITN use

Collective Engagement: Engage community members in local ownership of malaria control efforts to ensure community access to ITNs

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Insecticide-Treated Net Use

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