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Barriers to treated bednet usage in Timor-Leste: an explaratory study

Timor-Leste has some of the highest malaria rates in Asia- the WHO reports that 100% of the population is at year-round risk. A 2007 survey estimated that ITN usage (30 day) was only 28.8% in the under-5 population, and the MDG report also highlights several large disparities in ITN usage across the population- 69.6% urban and 45.5% rural; and 54% of males and only 46% of females, according to the Timor-Leste National Statistics Directorate (2007) and The Millennium Development Goals, Timor-Leste (2009). There have been many qualitative surveys about attitudes towards ITN usage in Sub-Saharan Africa, but far fewer from SE Asia [1].

To more fully understand the barriers to usage in Timor-Leste, a series of nine focus group discussions were organized in July, 2010. These discussions covered a range of peri-urban and rural areas, and were separated by sex, to allow exploration of intra-household decision making processes. A total of 53 women and 46 men participated, all of whom were heads of households or decision makers, and owned at least one bednet. A range of social, logistic and economic barriers emerged from these discussions, and could facilitate the creation of more targeted behavior-change materials.


  1. Morrow M, Quy A, Nguyen QA, et al: Pathways to malaria persistence in remote central Vietnam: a mixed-method study of health care and the community. BMC Public Health. 2009, 9: 85-10.1186/1471-2458-9-85.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Lover, A., Sutton, B. & Asy, A. Barriers to treated bednet usage in Timor-Leste: an explaratory study. BMC Proc 5 (Suppl 1), P16 (2011).

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