In 2024, we visited three of the most malaria-affected areas in Palawan to look closely at one question. Are insecticide-treated nets being used the way they are meant to be? With support from Pilipinas Shell Foundation, Inc., we conducted a bed net utilization study in Rizal, Brooke’s Point, and Bataraza, where malaria continues to take a toll on communities.
We surveyed 393 households, covering nearly 2,000 individuals, to understand how residents use, care for, and think about long-lasting insecticidal nets. It was not just about numbers. We wanted to learn what happens after the nets are handed out. Who sleeps under them? What keeps people from using them? What do communities believe about malaria and prevention?
High Access, But Uneven Use
Most households had nets. About 97 percent of residents had access, and almost all pregnant women and young children slept under one the night before the survey. That is encouraging. But access is not the same as consistent use.
In our interviews, some people said they avoided sleeping under nets because of heat or discomfort. Others used them for other purposes, like covering crops or as blankets. Some residents still believed that malaria came from spoiled food or dirty water, not mosquito bites.
Beliefs and Barriers on the Ground
Even in communities that understood the importance of nets, other challenges got in the way. In upland areas, difficult terrain and limited road access made it hard for health workers to reach households regularly. Follow-up visits, health education, and net replacement were harder to sustain.
Despite these issues, most residents expressed that nets helped protect them from mosquito bites and disease. The intent to use was there. The goal now is to remove the barriers that stop that intent from becoming habit.
What We Recommend
Health promotion efforts need to meet people where they are. Campaigns must be more community-based, using local dialects and cultural practices to explain why nets matter. Training local leaders and indigenous community members as advocates can help make messages more trusted and effective.
Logistical challenges must also be addressed. Health workers need better support to access remote barangays and follow up with families. Distribution programs should always include proper instruction on net use and maintenance.
Above all, malaria prevention must respect local customs while offering practical guidance. People are more likely to adopt health tools when they are presented in ways that fit into their everyday lives.
Why It Matters
Malaria cases in Palawan reached nearly 8,000 in 2024. With the national goal of eliminating malaria by 2030, every barrier to prevention needs to be addressed. This study shows that while nets are reaching communities, there is more work to do in turning that access into consistent protection.
Understanding how households view and use their nets gives us the insights needed to improve strategy. The fight against malaria will not be won by distribution alone. It will be won by making sure every household sees the net not just as a giveaway, but as a daily tool for survival.
If you would like a copy of the full report or want to learn more about the findings, feel free to contact us. We are ready to share the details and support action toward a malaria-free Philippines.