Nearly every minute, a child under five dies from malaria. Despite significant progress in reducing the disease in the last two decades, malaria continues to cause over 200 million infections and over 600,000 deaths each year.
The Behavioural Insights Team (BIT) is a world leader in behavioural science, having completed over 1700 projects and conducted more than 800 randomised controlled trials designing and evaluating behavioural interventions. BIT will join a project partnership with Malaria Consortium — one of the world’s leading non-profit organisations specialising in the prevention, management, control and elimination of malaria and other communicable diseases — to develop a low-cost intervention to increase the use of insecticide-treated nets (ITNs) in communities in Nigeria and Uganda. The project is funded by philanthropic donations via GiveWell, a non-profit organisation focused on identifying outstanding giving opportunities.
Over 90% of malaria cases and deaths occur in sub-Saharan Africa. ITNs are among the most effective vector control methods to prevent the disease and are particularly powerful when used in combination with other tools and innovations, such as new malaria vaccines, the first of which was approved by WHO last year. In affected communities, ITNs will continue to be a cornerstone of malaria prevention even as a vaccine becomes widely available. Over the years, billions of ITNs have been distributed in these regions, and are estimated to have prevented nearly 450,000,000 cases of malaria.
The problem
In recent years, global progress towards eliminating malaria has stalled due to reductions in funding. In this context, reducing malaria will depend on optimising the impact of existing innovations. One challenge relating to ITNs is low use rates. Even in households that have ITNs, they are not used every night.
Several factors contribute to this issue, including practical limitations of the nets, such as their design, as well as personal factors like discomfort when sleeping under them, wear and tear of nets, varying perceptions of malaria risk, and cultural beliefs.
With new innovations like malaria vaccines being rolled out, it is important to maintain the use of existing tools in reducing malaria. Concerns exist that the vaccine may cause people to overestimate its protection and neglect other preventive measures, such as ITNs, further reducing their use.
Our project
The Behavioural Insights Team and Malaria Consortium are partnering to research the factors that influence net use in Nigeria and Uganda, using community-based qualitative research and observation work.
Drawing on our behavioural expertise, we will develop a low-cost intervention to encourage consistent use of nets in these communities. This prototype will be extensively user-tested and piloted, before a potential rigorous evaluation.
To our knowledge, this is one of the first major projects worldwide to apply behavioural insights to malaria prevention.
Our approach will focus on pragmatic solutions, rigorous evidence and close collaboration with local communities, experts and stakeholders. We are looking forward to bringing our unique behavioural lens and experience from over 250 public health projects to this vital topic and learning from Malaria Consortium’s extensive expertise in disease prevention, control and treatment, as well as in conducting research with vulnerable populations and working with them to co-develop appropriate solutions.
David Halpern CBE, President and Founding Director of BIT:
“We believe behavioural science can help make great strides when applied to highly impactful cost-effective interventions in international development. We’re grateful to GiveWell for supporting the unique partnership between malaria prevention experts and behavioural scientists to bring a new perspective on a disease that continues to kill over half a million people a year. We’re looking forward to working closely with local communities, stakeholders and experts to develop innovative solutions for ITN usage that could help in the fight against one of the world’s most deadly infectious diseases.”
Katherine Theiss-Nyland, Technical Director of Malaria Consortium:
“By utilising behavioural insights to drive the uptake and use of proven prevention methods like ITNs, we have the potential to improve the impact of these interventions and save countless lives, especially those of young children. Our work aims to bridge the gap between net distribution and consistent use, addressing one of the key challenges in malaria prevention efforts. By leveraging behavioural science, we aim to ensure that more families in Nigeria and Uganda consistently protect themselves from this deadly disease. Our goal is to develop practical, community-driven solutions that will increase ITN usage, thereby reducing morbidity and mortality.”
