economics Practical Magic

We're failing to stop malaria with free mosquito nets because of a myth that the chemicals in them go bad after a year.

March 26, 2026

Original Paper

The Universal Access Paradox: A Cross-Sectional Evaluation of Long-Lasting Insecticidal Treated Net Ownership and Utilization Discrepancies among Pregnant Women in Nkoranza South District, Ghana

Richmond Yaw Osei, Ishmael Awini Aburi, Gabriel Osei Forkuo

SSRN · 6464678

The Takeaway

Despite near-universal ownership of life-saving nets, usage remains below 50% in some regions. The 'paradox' is driven by a specific cognitive error: many owners believe the insecticide becomes 'obsolete' long before it actually does, leading them to stop using effective protection.

From the abstract

Background: Malaria in pregnancy remains a leading cause of maternal and neonatal morbidity in sub-Saharan Africa. While long-lasting insecticidal treated nets are highly efficacious and cost-effective, consistent utilization often falls short of programmatic targets even when ownership is high. This study evaluated factors associated with the access to and utilization of these nets among pregnant women in Bonsu Sub-Municipality, Ghana. Methods: A descriptive cross-sectional study was conducted