Estimation of bed net coverage indicators using a national mobile phone survey in Tanzania

Estimation of bed net coverage indicators using a national mobile phone survey in Tanzania | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Estimation of bed net coverage indicators using a national mobile phone survey in Tanzania Matt Worges, Benjamin Kamala, Joshua Yukich, Frank Chacky, Samwel Lazaro, and 12 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1689414/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background: Monitoring and surveillance of bed net coverage indicators is critical, particularly due to threats in maintaining high population access to effective bed nets, but usually occurs every 2-3 years through large-scale national household surveys. However, the rapid growth of mobile phone ownership in Tanzania has resulted in mobile phone-based survey methodologies emerging as an alternative to household surveys. Methods: A national mobile phone survey was conducted in early 2021 with focus on bed net ownership and access. Half of the sample target was contacted through a standard random digit dial methodology and the remaining half was reached through a voluntary opt-in respondent pool. Both sampling approaches used an interactive voice response survey conducted in Kiswahili. Results: The response rate was approximately 1.5% across the combined sampling approaches. Population access (i.e., the percent of the population that could sleep under a bed net, assuming one bed net per two people) varied from a regionally adjusted low of 48.1% (Katavi) to a high of 65.5% (Dodoma). The adjusted percent of households that had a least one bed net ranged from 54.8% (Pemba) to 75.5% (Dodoma); the adjusted percent of households with at least one bed net per 2 de facto household population ranged from 35.9% (Manyara) to 55.7% (Dodoma). The estimates produced by both sampling approaches were generally similar, differing by only a few percentage points. An analysis of differences between estimates generated from the two sampling approaches showed minimal bias when considering variation across the indicator for households with at least one bed net per two de facto household population. Conclusion: Mobile phone surveys can provide rapid estimates of bed net coverage in Tanzania and may serve as a suitable source of information between large-scale household surveys. The results generated by this survey show that overall bed net access in the country appears to be lower than target thresholds. The results suggest that bed net distribution is needed in large sections of the country to ensure that coverage levels remain high enough to sustain protection against malaria for the population. ITN mobile phone survey random digit dial coverage indicators Tanzania Figures Figure 1 Background Malaria is a major public health issue and it is estimated that 229 million cases occurred globally in 2019, with Africa experiencing the largest burden (1, 2). It is endemic throughout most of mainland Tanzania and in Zanzibar (1, 3), and is a major cause of morbidity and mortality among children under five years of age and pregnant women (1). According to Tanzania Demographic and Health Surveys (DHS), prevalence of malaria in children under five years of age declined by half from 18% in 2007-08 to 9% in 2011-12 and then rose to 14% in 2015-16 (4–6). The 2017 Malaria Indicator Survey (MIS) data show a reduction in malaria prevalence from about 14% in 2015-16 to 7.5%; however, malaria parasite prevalence demonstrates a high degree of regional variation ranging from 24.4% to near zero (3). Due to the high prevalence and burden of malaria in Tanzania, the National Malaria Control Program (NMCP) and the Zanzibar Malaria Elimination Program (ZAMEP), in collaboration with their partners, implement several recommended preventive and curative interventions. One of the primary preventive strategies for reducing malaria transmission is the distribution and use of insecticide-treated bed nets (ITNs). Bed nets have been responsible for an estimated 68% reduction in global malaria cases since 2000 (7). In Tanzania, the continuing efforts of the NMCP, ZAMEP, and their partners have achieved and largely sustained high population access to ITNs over the past several years. Globally, malaria control strategies are moving towards stratification by malaria prevalence to improve targeting of interventions and further reduce transmission and risk. Tanzania is at the forefront of this movement, having stratified its approaches at a council level in the latest National Strategy (8). This National Strategy calls for a blend of ITN distribution channels depending on a council’s designated stratum with low, moderate, and high transmission settings delivering ITNs through annual school distributions, at reproductive and child health services (first antenatal clinic and immunization visits, respectively), and in mass campaigns when necessary. In very-low transmission strata, only ITN distribution via reproductive and child health services is implemented, and in urban locales ITNs are expected to be available in the commercial sector. The 2020 mass replacement campaign was implemented in 50 districts across 12 regions of mainland Tanzania; the other 14 regions of the mainland have implemented annual school distributions for the past 5–8 years, supported by the President’s Malaria Initiative, increasing the need for annual monitoring to inform quantifications for the subsequent year to maintain ITN access at high levels. Zanzibar has implemented a combination of mass campaigns, antenatal care distribution, and community-based distribution. However, threats to maintaining high population access with effective bed nets are growing. Decreased bed net access resulting, in part, from insufficient quantification, bed net wear and tear, and inefficiencies in distribution activities requires monitoring and surveillance to adapt and respond with appropriate interventions (3, 9). Monitoring and surveillance of bed net distribution and coverage typically rely on household surveys, which are expensive, time consuming, and infrequent (10). Alternatives such as lot quality assurance sampling surveys have been used in Tanzania and elsewhere, but such approaches are still household based and require significant investments in logistics and transportation (11–14). In addition, given the COVID-19 pandemic, it was preferable to collect data using a method that eliminates face-to-face contact such as mobile phone surveys, which can protect both the participant and the interviewer. Due to improvements in the affordability of mobile technology and ongoing network deployments to increase coverage areas, mobile phone ownership in low- and middle-income countries (LMIC) has rapidly increased (15–19). This growth has resulted in mobile phone-based survey methodologies emerging as a comparatively inexpensive alternative to large scale population-based household surveys (20–24). In LMIC settings, the use of random digit dialing (RDD) presents as an increasingly viable mobile phone survey option (25–27). A previous interactive voice response (IVR) random digit dial (RDD) mobile phone survey was conducted in Tanzania immediately following the 2017 MIS (unpublished data). The study demonstrated that while the degree of regional concordance between the RDD mobile phone survey and the 2017 MIS varied by assessed bed net indicator, generally the minimum, median, and maximum values for each indicator were consistent, suggesting that RDD mobile phone surveys are an acceptable, lower cost option for monitoring bed net coverage in Tanzania. The current study explores the use of a known-number sampling methodology in addition to an RDD approach to assess any apparent bias and efficiency gains in sampling from a frame of opt-in survey participants. Indicators of interest for this paper focus on bed net ownership and access in mainland Tanzania and Zanzibar. Methods Viamo, the mobile phone survey operator, conducted the mobile phone survey using an IVR method and targeted a maximum sample size of 7,000 finished surveys (see Additional File 1 for a list survey questions). The survey ran from January to March of 2021. Half (n = 3,500) of the target was planned to be reached through a standard RDD methodology and the remaining half was planned to be reached by sampling from a voluntary opt-in respondent pool to allow for comparison of the two approaches. The opt-in respondent pool consisted of respondents who had previously volunteered to be contacted as participants for mobile phone surveys. For both sampling approaches, Viamo programmed pre-recorded voice instructions in Kiswahili and respondents used the numeric keypad to input responses to a brief set of questions. In both samples, potential participants were recruited until regional quotas were met. RDD sampling approach. In the RDD approach, Viamo dialed phone numbers at random to generate a pool of potential participants. Tanzania has a 12-digit mobile number structure with a prefix of 255 (the country code) followed by a three-digit secondary prefix of 51 different possibilities. From among the 51 different trunk number sequences, the final six digits are those that were randomly generated one at a time for each call. Opt-in respondent pool sampling approach. The mobile network operator, Vodacom, shared with Viamo an ‘opt-in’ database of Tanzania-based phone numbers for respondents who reported that they would be willing to participate in mobile phone surveys related to health and well-being. The ‘opt-in’ database includes information on the geographical location of all individuals thereby reducing the number of cascade-style questions necessary to obtain a respondent’s region of residence. In utilizing the opt-in survey approach, the call center randomly sampled from geographic zone-specific blocks of numbers until regional quotas were met. The date that a Vodacom subscriber opted into the survey program is included in the opt-in database and Viamo was able to prioritize phone numbers who had opted into the survey program within the 12 months preceding the survey. In the event there was difficulty reaching targeted sample sizes, the mobile phone survey operator was able to sample from older participant rolls. Sample Size and Data collection. For the IVR mobile phone survey, it was estimated that the precision of the estimate within each region should be similar to the precision obtained in a DHS or MIS. In a recent Tanzania DHS (2015–2016) and MIS (2017), approximately 400 households were chosen in approximately 20 enumeration areas per region. Assuming an 80% baseline ownership of at least one bed net at the household level a sample of 440 households in a cluster sample with a design effect of 2 has approximately 80% power to detect a difference of seven percentage points. This means that a mobile phone survey with a regional sample size of approximately 250 households should yield a similar precision assuming simple random sampling. The regional sample size target was split between two contact/sampling methods with a goal of 125 finished surveys per region from both the RDD and opt-in methods described above. Outcomes. In addition to project-specific indicators of interest, the primary outcomes for this monitoring activity include the following Roll Back Malaria Partnership to End Malaria-Monitoring and Evaluation Reference Group (RBM-MERG) indicators (28): 1. Percent of households with at least one bed net of any type 2. Percent of households with at least one bed net of any type for every two people 3. Percent of de facto household population with access to a bed net of any type within their household. Two non-RBM-MERG bed net indicators were also calculated: 1. Percent of bed nets self-reported by respondents as purchased 2. Percent of bed nets self-reported by respondents as originally or ever having been treated with insecticide The non-RBM-MERG indicators were calculated at the bed net level. All bed net indicators were estimated by region and separately for the entirety of mainland Tanzania and Zanzibar. Definitions Standard definitions from the American Association for Public Opinion Research (AAPOR) were used to describe the contact (CON3), response (RR5 and RR6), cooperation (COOP1 and COOP2), and refusal/break-off (REF3) rates for the RDD survey (29). These measures are defined below where I = complete interview, P = partial interview, R = refusal and break-off, NC = non-contact, and O = other. Table 1 below describes the AAPOR call dispositions used to classify respondent calls. $$CON3=\frac{\left(I+P\right)+R+O}{\left(I+P\right)+R+O+NC}$$ $$RR5= \frac{I}{\left(I+P\right)+\left(R+NC+O\right)}$$ $$RR6= \frac{I+P}{\left(I+P\right)+\left(R+NC+O\right)}$$ $$COOP1=\frac{I}{\left(I+P\right)+R+O}$$ $$COOP2=\frac{(I+P)}{\left(I+P\right)+R+O}$$ $$REF3=\frac{R}{\left(I+P\right)+\left(R+NC+O\right)}$$ Table 1 Call Disposition Descriptions Disposition Description Complete Complete interview designations required that participants answer the questions necessary for calculation of the bed net indicators of interest as well as those for poststratification adjustment (i.e., bicycle, TV, and radio ownership). Partial Partial interview designations only required that participants answer the questions necessary for calculation of the bed net indicators of interest, but not those used for poststratification adjustment. Breakoff Breakoff interview designations denote those interviews in which a participant started answering questions, but ultimately broke off the call before a designation of complete or partial could be established. Refusal Refusals were characterized by respondents who indicated that they were not interested in participating in the survey. Non-contact Non-contact interviews are those in which the participant could not be reached (no answer or non-assigned phone number). Other If an interview was designated as anything other than complete, partial, breakoff, or refusal, it was dispositioned as ‘other’. In most instances, a designation of ‘other’ resulted from skipped questions necessary for a disposition of complete/partial, but in which the respondent finished the survey. Ineligible* Ineligible respondents are those who were under the age of 18 years or those whose call was ended as the sample quota had been reached for their region. Finished* Finished interviews was used as an internal program designation and was used to track progress towards sample size goals. This would include calls dispositioned as complete, partial, and other so long as the participant reached the end of the survey. As such, while this designation was used to track progress towards sample size goals, this category of interviews is not meaningful from an analytic perspective. *Not an official AAPOR disposition category: the AAPOR provides guidance on dispositioning calls but encourages researchers to establish a priori definitions of what constitutes a complete vs. a partial interview and what distinguishes a partial interview from a break-off. Otherwise, prescribed equations are provided for calculating rates (i.e., response, cooperation, refusal, and contact rates) using call dispositions. Note that regardless of call disposition status, the RBM-MERG bed net coverage indicators were calculated if the requisite data elements were available. Based on the call disposition categories described in Table 1 , the number of finished interviews is higher than the number of complete/partial interviews, and complete interviews, being more restrictive in their designation, are a subset of partial interviews. All available data points were taken into consideration for calculation of each individual indicator of interest regardless of call disposition status, which resulted in differing sample sizes across indicators for the same regions. Data analysis. Unweighted/unadjusted estimates were calculated for all indicators of interest. Following the initial analysis, poststratification adjustment was used to weight regional bed net indicator estimates. The marginal proportions of radio, TV, and bicycle ownership as well as region were calculated from the 2017 MIS and corresponding attributes from the combined RDD/opt-in surveys were raked to these MIS marginal proportions. Including region in the raking process ensured poststratification adjustment by the necessary administrative unit. All values in the narrative component of the report present adjusted indicator estimates. Additionally, logistic regression analyses were run for the two household-level RBM-MERG indicators with survey approach (RDD vs opt-in) as the outcome variable and household-level bed net indicator values used as predictor variables. Each regression controlled for region, radio and bicycle ownership, and household size. Results A total of 310,151 calls were placed to 246,233 unique phone numbers (Table 2 ). Of the total calls placed, 163,748 contacts were made (including refusals & breakoffs, partial/complete interviews, other classifications, and ineligible respondents – see Table 1 for a description of call dispositions). Of the 163,748 contacts made, 6,968 participants made it to the end of the survey regardless of whether they answered each question along the way (i.e., they may have skipped certain questions, but still finished the survey). A total of 3,020 interviews were designated as complete, meaning all bed net indicators of interest for these respondents could be calculated and for which poststratification adjustment could be conducted. Interviews designated as ‘complete’ were used to calculate overall response rate. The percent of finished interviews varied by region from 177% of target (Unguja region; n = 443) to 48% of target (Pemba region; n = 121). The response rate was approximately 1.5% across the combined RDD and opt-in survey methodologies. Because the opt-in method was expected to have fewer non-contact calls by virtue of the opt-in nature of the program, the cooperation rate, defined in Table 2 , can be assessed to get an alternative indication of successful interviews as non-contacts are removed from the denominator. This metric was calculated at 2.7% for complete interviews. Table 2 also presents call characteristics by survey method (RDD and opt-in). Nearly one-quarter (24.9%) of calls placed to the opt-in group were designated as non-contacts. The cooperation rates between the two methods differed by about 0.8 percentage points in favor of the opt-in method. The average length of surveys with a call disposition of complete or partial was just under ten minutes. Table 2 Call characteristics and AAPOR call disposition by method Calls Combined methods RDD method only Opt-in method only Total calls placed 310,151 142,946 167,205 Total unique numbers called 246,233 (79.4%) 138,728 (97.0%) 107,505 (64.3%) Call disposition (NC) Non-contacts 82,485 (33.5%) 55,673 (40.1%) 26,812 (24.9%) (R) Refusals & break-offs 127,375 (51.7%) 74,741 (53.9%) 52,634 (49.0%) (P) Partial interviews 3,192 (1.3%) 1,551 (1.1%) 1,641 (1.5%) (I) Completed interviews 3,020 (1.2%) 1,462 (1.1%) 1,558 (1.4%) (O) Other 5,448 (2.2%) 2,053 (1.5%) 3,395 (3.2%) Ineligible respondents† 27,733 (11.3%) 4,710 (3.4%) 23,023 (21.4%) AAPOR designations Contact rate 3 ( CON3 ): (I + P) + R + O/(I + P) + R + NC + O 62.2% 58.5% 68.3% Response rate 5 ( RR5 ): I/((I + P)+(R + NC + O)) 1.4% 1.1% 1.8% Response rate 6 ( RR6 ): (I + P)/((I + P)+(R + NC + O)) 1.5% 1.2% 1.9% Cooperation rate 1 ( COOP1 ): I/(I + P) + R + O) 2.2% 1.9% 2.7% Cooperation rate 2 ( COOP2 ): (I + P)/((I + P) + R + O)) 2.3% 2.0% 2.8% Refusal rate 3 ( R3 ): R/((I + P)+(R + NC + O)) 58.3% 55.8% 62.3% Survey Details Average survey length (I + P) 9 min 51 sec 9 min 49 sec 9 min 52 sec RDD random digit dial; AAPOR : American Association of Public Opinion Research min minutes; sec seconds †Not an official AAPOR designation – ineligible respondents were under the age of 18 years or were excluded from participation because their call exceeded the regional quota. Because respondents could skip or refuse to answer any question, the desired sample size of 250 respondents per region was not achieved for all assessed indicators despite reaching 99.5% of the overall target of finished interviews (6,968 of 7,000). The indicator for households with at least one bed net of any type had at least 250 valid responses for all regions except for Pemba where the sample size was 213 households or 81.5% of the target. For the other two assessed RBM-MERG indicators (percent of households with at least one bed net of any type for every two people and percent of de facto household population with access to a bed net of any type within their household), the desired sample size of 250 households was not reached for Katavi, Lindi, Mtwara, Rukwa, and Pemba regions. Aside from Pemba, which only reached 48% of the target, each of the aforementioned regions was within approximately 75% of the target. Additional File 2 shows the number of observations available by region to calculate assessed indicators. The results for the three assessed RBM-MERG indicators are shown in Table 3 . Population access to a bed net varied from an adjusted low of 48.1% in Katavi region to an adjusted high of 65.5% in Dodoma region. The adjusted percent of households that had a least one bed net ranged from 54.8% (Pemba) to 75.5% (Dodoma); the adjusted percent of households with at least one bed net per 2 de facto household population ranged from 35.9% (Manyara) to 55.7% (Dodoma); and the de facto household population access to a bed net ranged from an adjusted percent of 48.1% (Katavi) to 65.5% (Dodoma). Unweighted estimates are generally lower than those produced from the poststratification process for households with at least one bed net. The average regional difference between the two estimations is + 2.6 percentage points for this indicator although six regions exceed a difference of + 5 percentage points. Three-quarters of the regional estimates for both households with at least one bed net per two de facto household population and population access to a bed net were within ± 4 percentage points across the two estimates. Overall, adjusted regional estimates for households with at least one bed net per two de facto household population were generally lower than the unweighted estimates whereas the opposite is true of population access to a bed net. Additional non-RBM MERG indicators were also calculated including the percent of bed nets self-reported by survey respondents as purchased from an adjusted low of 18.9% (Songwe) to an adjusted high of 59.8% (Arusha) (Table 4 ). The indicator for the percent of bed nets self-reported by survey respondents to have ever been treated with insecticide which ranged from an adjusted low of 24.0% (Ruvuma) to an adjusted high of 56.2% (Mbeya). Table 3 Unweighted and adjusted RBM-MERG bed net indicator estimates by region Household has 1 + bed net Household has 1 + bed net per 2 de facto population De facto population access to a bed net Unweighted† Adjusted* % pt. diff. Unweighted† Adjusted* % pt. diff. Unweighted† Adjusted* % pt. diff. % [95% CI] % [95% CI] % [95% CI] % [95% CI] % [95% CI] % [95% CI] Mainland 65.5 [64.6, 66.3] 68.4 [67.1, 69.7] 2.9 50.5 [49.4, 51.5] 48.1 [46.5, 49.6] -2.4 56.2 [55.0, 57.3] 57.3 [55.6, 59.0] 1.1 Zanzibar 53.0 [49.7, 56.2] 55.4 [49.7, 61.0] 2.4 42.4 [38.2, 46.7] 43.8 [36.7, 51.0] 1.4 44.9 [40.0, 49.8] 49.1 [40.9, 57.2] 4.2 Arusha 56.1 [52.2, 60.1] 61.6 [55.4, 67.9] 5.5 38.2 [33.8, 42.7] 36.6 [30.0, 43.3] -1.6 45.7 [43.9, 47.5] 48.7 [41.8, 55.5] 3.0 Dar es salaam 68.9 [65.1, 72.6] 70.4 [64.4, 76.4] 1.6 53.9 [49.2, 58.7] 50.4 [43.1, 57.6] -3.6 63.3 [61.5, 65.1] 62.0 [53.9, 70.1] -1.4 Dodoma 69.8 [65.9, 73.7] 75.5 [69.7, 81.3] 5.7 58.1 [53.2, 62.9] 55.7 [48.4, 63.1] -2.3 63.4 [61.6, 65.3] 65.5 [57.9, 73.2] 2.1 Geita 65.9 [61.8, 70.1] 73.5 [67.7, 79.3] 7.5 49.1 [43.9, 54.4] 46.1 [38.8, 53.3] -3.1 54.9 [53.0, 56.9] 55.2 [47.0, 63.3] 0.2 Iringa 72.6 [68.9, 76.3] 78.4 [73.1, 83.8] 5.8 58.0 [53.4, 62.7] 55.4 [48.5, 62.4] -2.6 60.1 [58.2, 62.0] 64.9 [57.4, 72.4] 4.8 Kagera 68.9 [65.0, 72.8] 67.9 [62.0, 73.7] -1.1 52.2 [47.4, 57.1] 49.2 [42.1, 56.3] -3.0 59.4 [57.4, 61.3] 59.9 [52.2, 67.6] 0.5 Katavi 60.0 [54.4, 65.6] 56.9 [48.1, 65.7] -3.1 47.0 [39.8, 54.2] 46.6 [35.7, 57.4] -0.5 51.1 [48.4, 53.7] 48.1 [36.9, 59.4] -2.9 Kigoma 63.0 [58.5, 67.6] 70.4 [63.8, 77.1] 7.4 49.1 [43.2, 55.0] 52.5 [44.2, 60.8] 3.4 55.7 [53.4, 58.0] 62.2 [54.0, 70.5] 6.6 Kilimanjaro 60.8 [56.7, 65.0] 64.5 [58.3, 70.7] 3.7 44.8 [40.0, 49.7] 40.2 [33.3, 47.2] -4.6 48.4 [46.4, 50.3] 50.3 [43.1, 57.6] 2.0 Lindi 67.0 [61.8, 72.2] 68.6 [60.3, 77.0] 1.7 55.7 [48.8, 62.5] 55.6 [44.7, 66.5] -0.1 61.3 [58.9, 63.7] 60.7 [48.3, 73.1] -0.6 Manyara 60.2 [55.2, 65.2] 60.1 [51.9, 68.3] -0.1 46.8 [40.7, 53.0] 35.9 [26.6, 45.2] -10.9 50.3 [48.0, 52.6] 51.1 [40.1, 62.2] 0.8 Mara 69.8 [65.5, 74.0] 71.7 [65.8, 77.7] 2.0 46.8 [41.6, 52.1] 39.7 [32.8, 46.7] -7.1 57.8 [55.9, 59.7] 56.4 [49.5, 63.4] -1.4 Mbeya 67.8 [63.7, 71.8] 73.1 [66.9, 79.3] 5.4 53.8 [49.0, 58.7] 51.0 [43.3, 58.7] -2.8 55.8 [53.8, 57.8] 57.0 [48.8, 65.2] 1.2 Morogoro 64.6 [60.5, 68.7] 65.1 [58.7, 71.4] 0.5 53.8 [48.6, 58.9] 55.2 [47.3, 63.2] 1.5 58.9 [56.8, 60.9] 56.9 [47.3, 66.4] -2.0 Mtwara 64.0 [58.4, 69.5] 68.5 [59.8, 77.2] 4.5 49.2 [42.1, 56.3] 52.4 [41.5, 63.3] 3.2 51.4 [48.6, 54.2] 56.6 [45.1, 68.1] 5.2 Mwanza 68.4 [64.7, 72.0] 72.1 [66.6, 77.5] 3.7 53.0 [48.4, 57.7] 55.3 [48.6, 62.1] 2.3 60.9 [59.1, 62.6] 63.6 [56.2, 71.1] 2.8 Njombe 60.7 [55.8, 65.6] 63.0 [55.6, 70.4] 2.2 48.0 [42.4, 53.6] 51.4 [43.2, 59.6] 3.4 52.6 [50.1, 55.0] 59.2 [49.9, 68.4] 6.6 Pwani 72.3 [67.8, 76.8] 76.3 [69.4, 83.2] 4.0 56.9 [51.1, 62.8] 52.9 [43.9, 61.9] -4.1 62.7 [60.4, 65.0] 64.2 [55.4, 73.0] 1.5 Rukwa 62.0 [56.8, 67.3] 63.2 [54.3, 72.0] 1.1 46.5 [39.9, 53.2] 46.1 [35.1, 57.1] -0.4 49.7 [47.2, 52.2] 56.6 [45.7, 67.6] 6.9 Ruvuma 68.9 [64.8, 73.1] 72.2 [66.1, 78.3] 3.3 53.4 [48.2, 58.7] 50.4 [43.0, 57.9] -3.0 58.3 [56.2, 60.4] 60.0 [51.8, 68.1] 1.7 Shinyanga 64.4 [60.1, 68.7] 65.3 [58.7, 71.9] 0.9 48.7 [43.4, 54.0] 42.5 [34.4, 50.5] -6.2 57.2 [55.1, 59.3] 53.4 [45.0, 61.8] -3.8 Simiyu 65.2 [60.5, 69.9] 68.0 [61.2, 74.9] 2.8 40.8 [35.0, 46.6] 37.8 [29.6, 45.9] -3.0 51.3 [49.2, 53.3] 51.8 [43.6, 59.9] 0.5 Singida 66.3 [62.2, 70.4] 68.0 [61.3, 74.7] 1.7 53.0 [47.8, 58.2] 50.8 [42.7, 58.9] -2.2 56.3 [54.4, 58.3] 57.4 [48.2, 66.7] 1.1 Songwe 58.4 [53.4, 63.3] 59.2 [51.1, 67.3] 0.8 47.3 [41.2, 53.4] 51.1 [41.8, 60.3] 3.8 48.2 [45.8, 50.5] 51.0 [40.1, 61.9] 2.8 Tabora 63.8 [59.7, 67.8] 67.0 [60.7, 73.4] 3.3 47.2 [42.1, 52.2] 43.4 [35.6, 51.2] -3.8 57.2 [55.3, 59.0] 59.1 [51.1, 67.1] 1.9 Tanga 66.7 [62.6, 70.8] 66.2 [59.5, 72.9] -0.5 55.8 [50.7, 61.0] 55.3 [47.2, 63.5] -0.5 59.6 [57.7, 61.4] 59.6 [50.4, 68.8] 0.0 Pemba 55.9 [49.2, 62.5] 54.8 [43.2, 66.4] -1.1 45.5 [36.6, 54.3] 48.4 [33.6, 63.1] 2.9 54.6 [51.3, 58.0] 50.3 [33.2, 67.4] -4.3 Unguja 52.1 [48.4, 55.8] 55.6 [49.1, 62.1] 3.5 41.5 [36.7, 46.4] 42.6 [34.4, 50.7] 1.1 41.9 [40.1, 43.8] 48.8 [39.6, 58.1] 6.9 †Calculated from all available data points regardless of the presence of values for variables used in the poststratification process. *Only records with available data points for poststratification adjustment could be used to produced adjusted estimates. As such, adjusted estimates are calculated from a truncated data set compared to the data set used to calculate the unweighted estimates. CI confidence interval; % pt. diff. percentage point difference Table 4 Non-RBM-MERG bed net indicators by region Bed nets self-reported as purchased Bed nets self-reported as originally or ever treated with insecticide Unweighted† Adjusted* % pt. diff. Unweighted† Adjusted* % pt. diff. % [95% CI] % [95% CI] % [95% CI] % [95% CI] Mainland 38.4 [36.8, 39.9] 38.9 [36.8, 41.0] -0.5 42.3 [40.6, 43.9] 38.6 [36.2, 41.0] -3.7 Zanzibar 40.1 [33.0, 47.1] 46.8 [35.6, 58.0] + 6.7 41.1 [34.4, 47.8] 42.8 [32.3, 53.4] + 1.7 Arusha 51.4 [48.5, 54.3] 59.8 [50.5, 69.0] + 8.4 37.0 [34.2, 39.7] 31.1 [21.5, 40.8] -5.8 Dar es salaam 48.5 [45.9, 51.2] 52.6 [42.5, 62.7] + 4.1 40.6 [38.1, 43.1] 37.0 [27.2, 46.8] -3.6 Dodoma 38.4 [35.7, 41.1] 40.9 [31.2, 50.5] + 2.4 49.3 [46.5, 52.2] 49.9 [38.2, 61.6] + 0.5 Geita 34.2 [31.5, 37.0] 34.3 [26.0, 42.6] + 0.0 41.3 [38.4, 44.1] 32.1 [22.6, 41.6] -9.2 Iringa 35.2 [32.6, 37.7] 31.5 [23.3, 39.7] -3.7 53.0 [50.3, 55.7] 55.2 [44.3, 66.2] + 2.2 Kagera 24.1 [21.8, 26.4] 25.6 [17.6, 33.6] + 1.5 34.9 [32.2, 37.6] 28.1 [18.4, 37.7] -6.8 Katavi 42.0 [38.2, 45.8] 53.4 [39.4, 67.3] + 11.3 37.9 [34.1, 41.6] 28.8 [13.2, 44.5] -9.0 Kigoma 33.9 [30.8, 37.0] 42.4 [30.2, 54.5] + 8.5 40.0 [36.8, 43.3] 40.5 [28.5, 52.5] + 0.4 Kilimanjaro 39.2 [36.3, 42.0] 36.0 [26.0, 46.1] -3.1 48.9 [45.9, 51.9] 33.7 [24.1, 43.4] -15.2 Lindi 47.0 [43.7, 50.4] 48.6 [35.6, 61.6] + 1.6 45.2 [42.0, 48.4] 46.2 [31.4, 61.0] + 1.0 Manyara 36.7 [33.4, 39.9] 37.4 [24.1, 50.7] + 0.7 46.2 [43.0, 49.5] 39.3 [22.6, 55.9] -7.0 Mara 40.7 [37.9, 43.4] 39.1 [29.7, 48.4] -1.6 45.8 [42.9, 48.6] 46.4 [36.4, 56.4] + 0.6 Mbeya 31.8 [28.9, 34.7] 39.1 [30.5, 47.8] + 7.3 47.2 [44.0, 50.5] 56.2 [45.8, 66.7] + 9.0 Morogoro 46.9 [44.1, 49.7] 45.8 [33.9, 57.8] -1.1 43.2 [40.5, 45.8] 41.8 [29.6, 54.0] -1.4 Mtwara 39.5 [35.7, 43.2] 44.1 [29.7, 58.5] + 4.6 41.7 [38.1, 45.3] 39.8 [24.2, 55.4] -1.9 Mwanza 33.8 [31.5, 36.1] 30.7 [23.3, 38.1] -3.1 38.1 [35.6, 40.5] 35.5 [26.3, 44.8] -2.5 Njombe 32.9 [29.5, 36.3] 32.8 [22.8, 42.9] -0.0 40.5 [36.8, 44.1] 42.6 [28.7, 56.5] + 2.1 Pwani 46.9 [43.7, 50.2] 51.6 [39.3, 63.9] + 4.7 43.1 [39.9, 46.4] 33.2 [20.8, 45.5] -10.0 Rukwa 33.3 [30.0, 36.7] 32.9 [21.9, 43.9] -0.4 35.4 [32.0, 38.9] 38.8 [23.3, 54.4] + 3.4 Ruvuma 41.5 [38.5, 44.4] 39.5 [29.0, 49.9] -2.0 32.8 [30.0, 35.6] 24.0 [15.7, 32.2] -8.9 Shinyanga 45.1 [42.2, 48.1] 48.8 [37.3, 60.3] + 3.6 33.8 [31.1, 36.4] 33.8 [23.4, 44.1] + 0.0 Simiyu 39.9 [36.5, 43.2] 39.6 [28.5, 50.7] -0.2 40.7 [37.7, 43.8] 37.4 [25.9, 48.8] -3.4 Singida 35.9 [33.3, 38.5] 30.5 [20.5, 40.6] -5.4 45.4 [42.6, 48.1] 39.2 [25.7, 52.7] -6.2 Songwe 24.0 [21.2, 26.8] 18.9 [10.5, 27.2] -5.1 39.0 [35.8, 42.2] 39.3 [24.6, 53.9] + 0.3 Tabora 35.7 [33.3, 38.2] 37.9 [28.9, 46.8] + 2.1 45.3 [42.7, 47.9] 38.7 [27.6, 49.7] -6.6 Tanga 39.7 [37.0, 42.3] 42.7 [30.9, 54.4] + 3.0 53.8 [51.1, 56.5] 43.6 [31.8, 55.4] -10.2 Pemba 39.6 [35.5, 43.7] 49.1 [26.8, 71.4] + 9.5 42.8 [38.7, 46.9] 36.0 [15.9, 56.0] -6.8 Unguja 40.3 [37.6, 42.9] 45.7 [33.0, 58.5] + 5.5 40.6 [38.0, 43.1] 45.6 [33.4, 57.7] + 5.0 †Calculated from all available data points regardless of the presence of values for variables used in the poststratification process. *Only records with available data points for poststratification adjustment could be used to produced adjusted estimates. As such, adjusted estimates are calculated from a truncated data set compared to the data set used to calculate the raw and unweighted estimates. CI confidence interval; % pt. diff. percentage point difference Table 5 presents the results of the secondary objective of the study: the comparison of a true RDD approach to that of an opt-in approach. Table 5 RDD vs opt-in method of calling: logistic regression analysis results Odds Ratio [95% CI] Household has 1 + bed net (of any type) *1.18 [1.03, 1.36] Household has 1 + ITN 1.06 [0.93, 1.21] Household has 1 + bed net (of any type) per 2 de facto ***1.26 [1.12, 1.43] Household has 1 + ITN per 2 de facto 1.06 [0.91, 1.25] Each logistic regression controlled for region, radio ownership, bike ownership, and household size. In each logistic regression equation, the opt-in method was set as the reference category. Observation counts exceeded 4,000 for each regression analysis. * p < 0.05; ** p < 0.01; *** p < 0.001 RDD random digit dial; CI confidence interval; ITN insecticide-treated bed net The difference in the RDD and opt-in method of calling respondents was significant at an alpha level of 0.05 for the indicators of households with at least 1 bed net (of any type) and households with at least 1 bed net (of any type) per 2 de facto household population. Assuming a national RDD base rate prevalence of 50% for households with at least 1 bed net, the corresponding prevalence for the national opt-in method is estimated to be 54.1% given an odds ratio of 1.18. Likewise, the indicator of household ownership of at least 1 bed net (of any type) per 2 de facto household population showed a significant difference between the two survey approaches and was associated with an odds ratio of 1.26. This is roughly consistent with a national RDD estimate of 50% prevalence corresponding to a national opt-in estimate of 55.8% prevalence. No significant differences between the two survey approaches were noted when assessing these same two indicators restricted to only ITN availability. Discussion The NMCP and ZAMEP have an established threshold of ≥ 80% de facto household population bed net access which constitutes an acceptable level of coverage. Bed net access levels below this threshold are likely to trigger additional ITN distribution response mechanisms. The results of the current study showed that no region met or exceeded the 80% threshold and in some regions the coverage estimates were rather low (~ 50% in eight regions) indicating an urgent need to ensure that additional ITNs are available. Indeed, the de facto household population access to a bed net ranged from an adjusted percent of 48.1% (Katavi) to 65.5% (Dodoma). Mobile phone survey estimates for the adjusted percent of households with at least one bed net per 2 de facto household population were also relatively low with 46.4% (16 of 28) of regions below 50%. However, nearly one-third (10 of 28; 35.7%) of regions were estimated to have at least 70% coverage of households with at least one bed net. The challenges of achieving and maintaining net access above 80% are significant, given the rates at which bed nets are lost to wear and tear and the challenges of reaching all households with sufficient bed nets when they need them (30, 31). The mobile phone survey used for this study employed two different methods to sample respondents. First, a standard RDD approach in which truly random numbers were dialed and secondly, an opt-in-based approach in which a set of pre-identified, opt-in participant phone numbers were sampled for dialing. The estimates produced by both approaches were generally similar. However, the opt-in approach achieved the sample size targets more rapidly and in a wider range of regions of the country including among smaller and more sparsely populated regions. The dual sampling strategy allowed for an assessment of the relative bias of the RDD versus the opt-in approach with respect to household-level bed net coverage indicators. This assessment showed that, while significant, differences between the two survey methodologies were small and would likely not have a programmatically meaningful impact (see caption of Fig. 1 ). Nationally, the two household-level bed net indicators were estimated to be within 5 percentage points by either sampling strategy. The magnitude of this difference is not likely to greatly alter the decision-making process. One explanation for the particularly low bed net coverage estimates noted for several regions may be attributable to the 2020 mass replacement campaign (MRC) conducted for mainland Tanzania. In 10 of the regions selected for the MRC, only certain districts received bed nets. As such, coverage estimates for these 10 regions may be lower than anticipated as this survey includes districts which did not receive replacement bed nets in 2020. For example, only two of Kilimanjaro’s seven districts were targeted for the 2020 MRC, while survey respondents may have resided anywhere within the region, potentially underestimating the overall coverage of Kilimanjaro. Similarly, two of six councils in Njombe and two out of seven councils in Manyara were targeted for the 2020 MRC, the latter of which experienced ongoing distribution at the time of the survey. Response rates for RDD IVR surveys are typically low, and it is common for breakoffs to occur quickly after successful contacts are made. A previous RDD mobile phone survey was conducted in Tanzania immediately following the 2017 MIS (unpublished data) which achieved a response rate (RR5) of 5.8% compared to the overall RR5 of 1.5% for the current survey. As an additional point of reference, a 2017 RDD IVR study conducted in Ghana reported achieving a response rate of 21% (32). The low response rates noted for the current study (RR5 of 1.1% and 1.8% for the RDD and opt-in methods, respectively) may be due to an increase in RDD IVR surveys in Tanzania as a precaution against exposing survey enumerators to COVID-19. The overall increase in such mobile phone surveys may lead to respondent fatigue. In addition, in the context of COVID-19, respondents may be preoccupied with other concerns and therefore less likely to respond. Opt-in respondents were collectively expected to demonstrate a higher response rate than participants from the RDD sampling pool, but, surprisingly, their RR5 metric was only slightly higher. The potential benefits from the opt-in approach are shorter call times for those individuals completing the survey due to truncated cascade-style questions on location of residence as well as more willing participants (i.e., a higher response rate) compared to the true RDD approach. Indeed, the opt-in sampling strategy made 31,223 fewer calls than the RDD method but yielded about 100 additional completed surveys. In general, non-coverage and non-response biases are potential issues when conducting mobile phone surveys in LMIC. As mobile phone penetration continues to increase across certain LMIC, however, non-coverage bias is gradually reduced (33, 34). Nevertheless, evidence from recent studies show that MPS tend to oversample male, urban, younger, and better educated respondents – all of whom are generally more likely to own mobile phones in LMIC settings suggesting that non-coverage bias remains an issue (16, 32, 35, 36). Mobile phone surveys also tend to underrepresent women in Africa, although it remains unclear the extent to which this underrepresentation reflects non-coverage bias or non-response bias (32, 37). The potential bias in participant type may lead to differential responses to questions concerning the general health and well-being of family members including report on protective measures such as availability and use of bed nets. The mobile phone survey questionnaire used for this research asked questions related to bed net use for pregnant women and children under five, but the sample size calculation was structured on household ownership of at least one net and did not factor in whether that household would have had members from these higher-risk groups. As such, few data points for these populations were available and calculation of net use indicators was not conducted. Sample size requirements for these target groups are likely to be too large to pragmatically conduct the mobile phone survey given general budget and time considerations. Conclusion Mobile phone surveys can provide rapid estimates of bed net coverage in Tanzania and may serve as a suitable source of information between large-scale household surveys. The veracity of estimates obtained from mobile phone surveys can be validated against household survey estimates, particularly if they are conducted contemporaneously. Based on the results generated by this survey, overall bed net access in the country appears to be lower than target thresholds, with some regions being especially low. The results suggest that bed net distribution is needed in large sections of the country to ensure that access levels remain high enough (above 80%) to permit high levels of bed net use and sustain protection of the population. Lastly, mobile phone survey sampling methodologies based on pre-existing, opt-in respondent lists may be a more efficient and simpler way to collect bed net coverage data compared to RDD methods. Abbreviations DHS Demographic and Health Surveys; MIS Malaria Indicator Survey; NMCP National Malaria Control Program; ZAMEP Zanzibar Malaria Elimination Program; ITN Insecticide-treated bed net; LMIC Low- and middle-income countries; IVR Interactive voice response; RDD Random digit dial; RBM-MERG Roll Back Malaria Partnership to End Malaria-Monitoring and Evaluation Reference Group; AAPOR American Association for Public Opinion Research; MRC Mass replacement campaign Declarations Ethics approval and consent to participate All research activities conformed to the Declaration of Helsinki (38). Ethical approval to conduct the study was received from the Tanzania National Institute for Medical Research (Ref. NIMR/HQ/R.8a/Vol. IX/3473). Participant consent was obtained from an affirmative response to a pre-recorded message that read out a short consent script at the beginning of the mobile phone survey. Consent for publication The permission to publish the findings was obtained from NIMR with approval number NIMR/HQ/P.12 VOL XXXIII/132 Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare they have no competing interests. Funding This work is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the President’s Malaria Initiative (PMI) under the terms of USAID/JHU Contract number 72062120C00001. The contents do not necessarily reflect the views of PMI or the United States Government. Authors' contributions MW, BK, JY, FC, SL, CD, SA, RI, MK, PG, DM, HM, SD, DD, NS, DL, and HK assisted in the design of the study, MW conducted the analysis and drafted the manuscript. MW, BK, JY, FC, SL, CD, SA, RI, MK, PG, DM, HM, SD, DD, NS, DL, and HK reviewed and approved the final manuscript. References World Health Organization. World Malaria Report 2020. Geneva, Switzerland: World Health Organization: Geneva: World Health Organization; 2020. Organization WH. World malaria report 2020: 20 years of global progress and challenges. Geneva; 2020. Ministry of Health CD, Gender E and C (MoHCDGEC) [Tanzania M, Ministry of Health (MoH) [Zanzibar], Tanzania NB of S (NBS), Office of the Chief Government Statistician (OCGS), ICF,. Tanzania Malaria Indicator Survey 2017. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF; 2017. Ministry of Health CD, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF,. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF; 2016. Tanzania Commission for AIDS (TACAIDS) ZACZ, National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and Macro International Inc,. Tanzania HIV/AIDS and Malaria Indicator Survey 2007-08. Dar es Salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and Macro International Inc.; 2008. Tanzania Commission for AIDS (TACAIDS) ZACZ, National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF International,. Tanzania HIV/AIDS and Malaria Indicator Survey 2011-12. Dar es Salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and ICF International; 2013. Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526(7572):207–11. The United Republic of Tanzania. Tanzania National Strategy for Vector Control, 2019–2024. Ministry of Health, Community Development, Gender, Elderly and Children: Ministry of Health, Community Development, Gender, Elderly and Children; 2019. Kilian A, Obi E, Mansiangi P, Abílio AP, Haji KA, Blaufuss S, et al. Variation of physical durability between LLIN products and net use environments: summary of findings from four African countries. Malaria Journal. 2021;20(1):26. Aday LA, Cornelious LJ. Designing and conducting health surveys. Third Edition ed: Wiley; 2011. Evaluation M. Report of a Technical Meeting on the Use of Lot Quality Assurance Sampling (LQAS) in Polio Eradication Programs. Chapel Hill, NC: Carolina Population Center University of North Carolina; 1998. Hoshaw-Woodard S. Description and comparison of the methods of cluster sampling and lot quality assurance sampling to assess immunization coverage. Geneva: World Health Organization; 2001. Singh J, Jain DC, Sharma RS, Verghese T. Evaluation of immunization coverage by lot quality assurance sampling compared with 30-cluster sampling in a primary health centre in India. Bull World Health Organ. 1996;74(3):269–74. Vanamail P, Subramanian S, Srividya A, Ravi R, Krishnamoorthy K, Das PK. Operational feasibility of lot quality assurance sampling (LQAS) as a tool in routine process monitoring of filariasis control programmes. Trop Med Int Health. 2006;11(8):1256–63. Minges M. Mobile cellular communications in the Southern African region. Telecomm Policy. 1999;23:585–93. GMSA Intelligence. The Mobile Economy - Sub-Saharan Africa 2014. 2014. Castells M, Qui JL, Fernandez-Ardevol M, Sey A. Mobile Communication and Society: A Global Perspective. Cambridge, MA: MIT Press; 2009. Ame AM, Jacob S. Relationship between network coverage and teledensity growth - case of giant telecommunication companies of Tanzania. International Journal of Management, IT and Engineering. 2013;3(5). Bank W. Information and Communications for Development: Maximizing Mobile. Washington, DC: World Bank; 2012. Ballivian A, Azevedo JP, Durbin W. Using Mobile Phones for High-Frequency Data Collection. In: Toninelli, D, Pinter, R & de Pedraza, P (eds.) Mobile Research Methods: Opportunities and Challenges of Mobile Research Methodologies: London: Ubiquity Press. DOI: http://dx.doi.org/10.5334/bar.c . License: CC-BY 4.0; 2015. Croke K, Dabalen A, Demombynes G, Giugale M, Hoogeveen J. Collecting High Frequency Panel Data in Africa Using Mobile Phone Interviews. In: The World Bank PRaEMU, Africa Region,, editor. 2012. Gibson DG, Pereira A, Farrenkopf BA, Labrique AB, Pariyo GW, Hyder AA. Mobile Phone Surveys for Collecting Population-Level Estimates in Low- and Middle-Income Countries: A Literature Review. J Med Internet Res. 2017;19(5):e139. Hyder AA, Wosu AC, Gibson DG, Labrique AB, Ali J, Pariyo GW. Noncommunicable Disease Risk Factors and Mobile Phones: A Proposed Research Agenda. J Med Internet Res. 2017;19(5):e133. Mahfoud Z, Ghandour L, Ghandour B, Mokdad AH, Sibai AM. Cell Phone and Face-to-face Interview Responses in Population-based Surveys. Field Methods. 2014;27(1):39–54. Hu SS, Balluz L, Battaglia MP, Frankel MR. The impact of cell phones on public health surveillance. Bull World Health Organ. 2010;88(11):799. Labrique A, Blynn E, Ahmed S, Gibson D, Pariyo G, Hyder AA. Health Surveys Using Mobile Phones in Developing Countries: Automated Active Strata Monitoring and Other Statistical Considerations for Improving Precision and Reducing Biases. J Med Internet Res. 2017;19(5):e121. World Bank. World Development Report 2016: Digital Divides. Washington, DC: World Bank; 2016. MEASURE Evaluation, The Demographic and Health Surveys, The President's Malaria Initiative, Roll Back Malaria Partnership, United Nations Children's Fund, World Health Organization. Household Survey Indicators for Malaria Control. 2018. The American Association for Public Opinion Research. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. 2016. Bertozzi-Villa A, Bever CA, Koenker H, Weiss DJ, Vargas-Ruiz C, Nandi AK, et al. Maps and metrics of insecticide-treated net access, use, and nets-per-capita in Africa from 2000–2020. Nature Communications. 2021;12(1):3589. Koenker H, Arnold F, Ba F, Cisse M, Diouf L, Eckert E, et al. Assessing whether universal coverage with insecticide-treated nets has been achieved: is the right indicator being used? Malaria Journal. 2018;17(1):355. L'Engle K, Sefa E, Adimazoya EA, Yartey E, Lenzi R, Tarpo C, et al. Survey research with a random digit dial national mobile phone sample in Ghana: Methods and sample quality. PLoS One. 2018;13(1):e0190902. Leo B, Morello R, Mellon J, Pieixoto T, Davenport S. Do mobile phone surveys work in poor countries? Washington, DC: Center for Global Development; 2015. Tran MC, Labrique AB, Mehra S, Ali H, Shaikh S, Mitra M, et al. Analyzing the mobile "digital divide": changing determinants of household phone ownership over time in rural bangladesh. JMIR Mhealth Uhealth. 2015;3(1):e24. Pew Research Center. Internet Connectivity Seen as Having Positive Impact on Life in Sub-Saharan Africa. 2018. Rheault M, McCarthy J. Disparities in cellphone ownership pose challenges in Africa: Gallop World Poll; 2015 [December 7, 2021]. Available from: https://news.gallup.com/poll/189269/disparities-cellphone-ownership-pose-challenges-africa.aspx . Lau CQ, Lombaard A, Baker M, Eyerman J, Thalji L. How Representative Are SMS Surveys in Africa? Experimental Evidence From Four Countries. International Journal of Public Opinion Research. 2019;31(2):309–30. World Medical Association. Ethics Unit. Declaration of Helsinki 2007 [Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ Additional Declarations No competing interests reported. Supplementary Files AdditionalFiles.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Major revision 05 Jul, 2022 Reviewers agreed at journal 20 Jun, 2022 Reviews received at journal 07 Jun, 2022 Reviewers agreed at journal 07 Jun, 2022 Reviewers invited by journal 07 Jun, 2022 Editor assigned by journal 27 May, 2022 Submission checks completed at journal 27 May, 2022 First submitted to journal 24 May, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1689414","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":109284586,"identity":"dde194ba-7544-4988-bb82-6258b3a9a92d","order_by":0,"name":"Matt Worges","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxUlEQVRIiWNgGAWjYLCCDyBCAogfMBwgRj0zY+OMBKiWhAQitTTzkKRFt/388ce2P+7JmUs3H/yQ+OMOA397dwJeLWZnkhmbcxKKjS3nHEuWSEh4xiBx5uwG/FoOgLUkJG64kWMA1HKYwUAil4CW848Zmy3AWvI//yBOyw2gLQwQW9iItOXGY8OZPWkJxpYz0swsEtIO8xD2y/nEBx9+2CTImUskP77xweawHH97L34tcGAApXmIU46sZRSMglEwCkYBBgAAOSdOBCP3BPAAAAAASUVORK5CYII=","orcid":"","institution":"PMI Tanzania Vector Control Activity, Tropical Health","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Matt","middleName":"","lastName":"Worges","suffix":""},{"id":109284587,"identity":"155cc113-0f1e-47ee-9282-5cf5af26c91d","order_by":1,"name":"Benjamin Kamala","email":"","orcid":"","institution":"PMI Tanzania Vector Control Activity, Johns Hopkins University School of Public Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Benjamin","middleName":"","lastName":"Kamala","suffix":""},{"id":109284588,"identity":"c19297ef-813c-496c-a9c3-01e30c60ecd0","order_by":2,"name":"Joshua Yukich","email":"","orcid":"","institution":"PMI Tanzania Vector Control Activity, Tropical Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Joshua","middleName":"","lastName":"Yukich","suffix":""},{"id":109284589,"identity":"3b612100-2b89-46f9-9d3a-4ae7798fc8a1","order_by":3,"name":"Frank Chacky","email":"","orcid":"","institution":"Tanzania National Malaria Control Program","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Frank","middleName":"","lastName":"Chacky","suffix":""},{"id":109284590,"identity":"755f347a-5039-4027-a5b2-8bd0f9ac5b99","order_by":4,"name":"Samwel Lazaro","email":"","orcid":"","institution":"Tanzania National Malaria Control Program","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Samwel","middleName":"","lastName":"Lazaro","suffix":""},{"id":109284591,"identity":"b9528946-5b8c-408c-b6b2-d51a7a8ea431","order_by":5,"name":"Charles Dismas","email":"","orcid":"","institution":"Tanzania National Malaria Control Program","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Charles","middleName":"","lastName":"Dismas","suffix":""},{"id":109284592,"identity":"b44046b0-6bc7-434a-9983-9f189ecab650","order_by":6,"name":"Sijenun Aroun","email":"","orcid":"","institution":"Tanzania National Malaria Control Program","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sijenun","middleName":"","lastName":"Aroun","suffix":""},{"id":109284593,"identity":"813adffa-c85a-49f3-80ca-076aa3d84c01","order_by":7,"name":"Raya Ibrahim","email":"","orcid":"","institution":"Zanzibar Malaria Elimination Program","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Raya","middleName":"","lastName":"Ibrahim","suffix":""},{"id":109284594,"identity":"7d980e2a-cd9b-485b-8233-4f37d2360fb2","order_by":8,"name":"Mwinyi Khamis","email":"","orcid":"","institution":"Zanzibar Malaria Elimination Program","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mwinyi","middleName":"","lastName":"Khamis","suffix":""},{"id":109284595,"identity":"e8bc6f77-35be-409e-8e51-db7ad5a0bc96","order_by":9,"name":"Peter Gitanya","email":"","orcid":"","institution":"Tanzania National Malaria Control Program","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Peter","middleName":"","lastName":"Gitanya","suffix":""},{"id":109284596,"identity":"1b0c2d67-2fc9-4d2d-9566-5eb9c4a60608","order_by":10,"name":"Deodatus Mwingizi","email":"","orcid":"","institution":"PMI Tanzania Vector Control Activity, Johns Hopkins University School of Public Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Deodatus","middleName":"","lastName":"Mwingizi","suffix":""},{"id":109284597,"identity":"fbe9f9f2-f97b-4898-864b-c1638e75e2ae","order_by":11,"name":"Hannah Metcalfe","email":"","orcid":"","institution":"Viamo","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hannah","middleName":"","lastName":"Metcalfe","suffix":""},{"id":109284598,"identity":"846e51e9-8459-4b4f-808d-e4693bd0b939","order_by":12,"name":"Sena Deku","email":"","orcid":"","institution":"Viamo","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sena","middleName":"","lastName":"Deku","suffix":""},{"id":109284599,"identity":"88aa03c1-0ade-4913-9b08-c58e4fcc3f92","order_by":13,"name":"David Dadi","email":"","orcid":"","institution":"PMI Tanzania Vector Control Activity, Johns Hopkins University School of Public Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"David","middleName":"","lastName":"Dadi","suffix":""},{"id":109284600,"identity":"632ea3c4-efab-46f7-8c0d-d16d0c6d17cd","order_by":14,"name":"Naomi Serbantez","email":"","orcid":"","institution":"U.S. President’s Malaria Initiative","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Naomi","middleName":"","lastName":"Serbantez","suffix":""},{"id":109284601,"identity":"3149f16f-64ae-4cf8-917c-e9a286d1c752","order_by":15,"name":"Dana Loll","email":"","orcid":"","institution":"PMI Tanzania Vector Control Activity, Johns Hopkins University School of Public Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Dana","middleName":"","lastName":"Loll","suffix":""},{"id":109284602,"identity":"c4d7944d-b42d-453b-a8e6-38724a89c6e5","order_by":16,"name":"Hannah Koenker","email":"","orcid":"","institution":"PMI Tanzania Vector Control Activity, Tropical Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hannah","middleName":"","lastName":"Koenker","suffix":""}],"badges":[],"createdAt":"2022-05-24 15:29:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1689414/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1689414/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":22085564,"identity":"6164358c-728d-4cfc-8e58-ba56586a7d01","added_by":"auto","created_at":"2022-05-31 16:32:06","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":86896,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of mobile phone survey approaches.\u003c/strong\u003e Using results from the regression output shown in Table 5, it is possible to estimate the difference in indicator values between the two survey approaches (RDD vs. opt-in method) for any base rate prevalence value. Given a strict decision rule to implement a mass distribution campaign once bed net access levels fall below a 50% threshold, a standalone opt-in survey methodology would erroneously trigger a campaign, assuming an RDD gold standard methodology, between prevalence values of 0.51 and 0.55 for households with at least one bed net per 2 de facto household population.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-1689414/v1/c4b3757397388f4a1562f9d6.png"},{"id":22085565,"identity":"6451369a-3b94-4217-85d8-d5bd4be05d6d","added_by":"auto","created_at":"2022-05-31 16:32:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":523602,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1689414/v1/3e2cc7da-fb9e-47ef-b306-3f0f5413bc60.pdf"},{"id":22085563,"identity":"a2e30840-57f5-4762-9ad0-05c8c41d62d4","added_by":"auto","created_at":"2022-05-31 16:32:06","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":14873,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFiles.docx","url":"https://assets-eu.researchsquare.com/files/rs-1689414/v1/eeb5ef1e762ccbf745919d67.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Estimation of bed net coverage indicators using a national mobile phone survey in Tanzania","fulltext":[{"header":"Background","content":"\u003cp\u003eMalaria is a major public health issue and it is estimated that 229\u0026nbsp;million cases occurred globally in 2019, with Africa experiencing the largest burden (1, 2). It is endemic throughout most of mainland Tanzania and in Zanzibar (1, 3), and is a major cause of morbidity and mortality among children under five years of age and pregnant women (1). According to Tanzania Demographic and Health Surveys (DHS), prevalence of malaria in children under five years of age declined by half from 18% in 2007-08 to 9% in 2011-12 and then rose to 14% in 2015-16 (4\u0026ndash;6). The 2017 Malaria Indicator Survey (MIS) data show a reduction in malaria prevalence from about 14% in 2015-16 to 7.5%; however, malaria parasite prevalence demonstrates a high degree of regional variation ranging from 24.4% to near zero (3).\u003c/p\u003e \u003cp\u003eDue to the high prevalence and burden of malaria in Tanzania, the National Malaria Control Program (NMCP) and the Zanzibar Malaria Elimination Program (ZAMEP), in collaboration with their partners, implement several recommended preventive and curative interventions. One of the primary preventive strategies for reducing malaria transmission is the distribution and use of insecticide-treated bed nets (ITNs). Bed nets have been responsible for an estimated 68% reduction in global malaria cases since 2000 (7).\u003c/p\u003e \u003cp\u003eIn Tanzania, the continuing efforts of the NMCP, ZAMEP, and their partners have achieved and largely sustained high population access to ITNs over the past several years. Globally, malaria control strategies are moving towards stratification by malaria prevalence to improve targeting of interventions and further reduce transmission and risk. Tanzania is at the forefront of this movement, having stratified its approaches at a council level in the latest National Strategy (8). This National Strategy calls for a blend of ITN distribution channels depending on a council\u0026rsquo;s designated stratum with low, moderate, and high transmission settings delivering ITNs through annual school distributions, at reproductive and child health services (first antenatal clinic and immunization visits, respectively), and in mass campaigns when necessary. In very-low transmission strata, only ITN distribution via reproductive and child health services is implemented, and in urban locales ITNs are expected to be available in the commercial sector. The 2020 mass replacement campaign was implemented in 50 districts across 12 regions of mainland Tanzania; the other 14 regions of the mainland have implemented annual school distributions for the past 5\u0026ndash;8 years, supported by the President\u0026rsquo;s Malaria Initiative, increasing the need for annual monitoring to inform quantifications for the subsequent year to maintain ITN access at high levels. Zanzibar has implemented a combination of mass campaigns, antenatal care distribution, and community-based distribution. However, threats to maintaining high population access with effective bed nets are growing. Decreased bed net access resulting, in part, from insufficient quantification, bed net wear and tear, and inefficiencies in distribution activities requires monitoring and surveillance to adapt and respond with appropriate interventions (3, 9).\u003c/p\u003e \u003cp\u003eMonitoring and surveillance of bed net distribution and coverage typically rely on household surveys, which are expensive, time consuming, and infrequent (10). Alternatives such as lot quality assurance sampling surveys have been used in Tanzania and elsewhere, but such approaches are still household based and require significant investments in logistics and transportation (11\u0026ndash;14). In addition, given the COVID-19 pandemic, it was preferable to collect data using a method that eliminates face-to-face contact such as mobile phone surveys, which can protect both the participant and the interviewer.\u003c/p\u003e \u003cp\u003eDue to improvements in the affordability of mobile technology and ongoing network deployments to increase coverage areas, mobile phone ownership in low- and middle-income countries (LMIC) has rapidly increased (15\u0026ndash;19). This growth has resulted in mobile phone-based survey methodologies emerging as a comparatively inexpensive alternative to large scale population-based household surveys (20\u0026ndash;24). In LMIC settings, the use of random digit dialing (RDD) presents as an increasingly viable mobile phone survey option (25\u0026ndash;27).\u003c/p\u003e \u003cp\u003eA previous interactive voice response (IVR) random digit dial (RDD) mobile phone survey was conducted in Tanzania immediately following the 2017 MIS (unpublished data). The study demonstrated that while the degree of regional concordance between the RDD mobile phone survey and the 2017 MIS varied by assessed bed net indicator, generally the minimum, median, and maximum values for each indicator were consistent, suggesting that RDD mobile phone surveys are an acceptable, lower cost option for monitoring bed net coverage in Tanzania. The current study explores the use of a known-number sampling methodology in addition to an RDD approach to assess any apparent bias and efficiency gains in sampling from a frame of opt-in survey participants. Indicators of interest for this paper focus on bed net ownership and access in mainland Tanzania and Zanzibar.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eViamo, the mobile phone survey operator, conducted the mobile phone survey using an IVR method and targeted a maximum sample size of 7,000 finished surveys (see \u003cstrong\u003eAdditional File 1\u003c/strong\u003e for a list survey questions). The survey ran from January to March of 2021. Half (n\u0026thinsp;=\u0026thinsp;3,500) of the target was planned to be reached through a standard RDD methodology and the remaining half was planned to be reached by sampling from a voluntary opt-in respondent pool to allow for comparison of the two approaches. The opt-in respondent pool consisted of respondents who had previously volunteered to be contacted as participants for mobile phone surveys. For both sampling approaches, Viamo programmed pre-recorded voice instructions in Kiswahili and respondents used the numeric keypad to input responses to a brief set of questions. In both samples, potential participants were recruited until regional quotas were met.\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eRDD sampling approach.\u003c/span\u003e In the RDD approach, Viamo dialed phone numbers at random to generate a pool of potential participants. Tanzania has a 12-digit mobile number structure with a prefix of 255 (the country code) followed by a three-digit secondary prefix of 51 different possibilities. From among the 51 different trunk number sequences, the final six digits are those that were randomly generated one at a time for each call.\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eOpt-in respondent pool sampling approach.\u003c/span\u003e The mobile network operator, Vodacom, shared with Viamo an \u0026lsquo;opt-in\u0026rsquo; database of Tanzania-based phone numbers for respondents who reported that they would be willing to participate in mobile phone surveys related to health and well-being. The \u0026lsquo;opt-in\u0026rsquo; database includes information on the geographical location of all individuals thereby reducing the number of cascade-style questions necessary to obtain a respondent\u0026rsquo;s region of residence. In utilizing the opt-in survey approach, the call center randomly sampled from geographic zone-specific blocks of numbers until regional quotas were met. The date that a Vodacom subscriber opted into the survey program is included in the opt-in database and Viamo was able to prioritize phone numbers who had opted into the survey program within the 12 months preceding the survey. In the event there was difficulty reaching targeted sample sizes, the mobile phone survey operator was able to sample from older participant rolls.\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eSample Size and Data collection.\u003c/span\u003e For the IVR mobile phone survey, it was estimated that the precision of the estimate within each region should be similar to the precision obtained in a DHS or MIS. In a recent Tanzania DHS (2015\u0026ndash;2016) and MIS (2017), approximately 400 households were chosen in approximately 20 enumeration areas per region. Assuming an 80% baseline ownership of at least one bed net at the household level a sample of 440 households in a cluster sample with a design effect of 2 has approximately 80% power to detect a difference of seven percentage points. This means that a mobile phone survey with a regional sample size of approximately 250 households should yield a similar precision assuming simple random sampling. The regional sample size target was split between two contact/sampling methods with a goal of 125 finished surveys per region from both the RDD and opt-in methods described above.\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eOutcomes.\u003c/span\u003e In addition to project-specific indicators of interest, the primary outcomes for this monitoring activity include the following Roll Back Malaria Partnership to End Malaria-Monitoring and Evaluation Reference Group (RBM-MERG) indicators (28):\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e1. Percent of households with at least one bed net of any type\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003e2. Percent of households with at least one bed net of any type for every two people\u003c/p\u003e\n\u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e3. Percent of de facto household population with access to a bed net of any type within their household.\u003c/p\u003e\n\u003c/span\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003eTwo non-RBM-MERG bed net indicators were also calculated:\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e1. Percent of bed nets self-reported by respondents as purchased\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003e2. Percent of bed nets self-reported by respondents as originally or ever having been treated with insecticide\u003c/p\u003e\n\u003c/span\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003eThe non-RBM-MERG indicators were calculated at the bed net level. All bed net indicators were estimated by region and separately for the entirety of mainland Tanzania and Zanzibar.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDefinitions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStandard definitions from the American Association for Public Opinion Research (AAPOR) were used to describe the contact (CON3), response (RR5 and RR6), cooperation (COOP1 and COOP2), and refusal/break-off (REF3) rates for the RDD survey (29). These measures are defined below where I\u0026thinsp;=\u0026thinsp;complete interview, P\u0026thinsp;=\u0026thinsp;partial interview, R\u0026thinsp;=\u0026thinsp;refusal and break-off, NC\u0026thinsp;=\u0026thinsp;non-contact, and O\u0026thinsp;=\u0026thinsp;other. Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e below describes the AAPOR call dispositions used to classify respondent calls.\u003c/p\u003e\n\u003cdiv class=\"Equation\" id=\"Equa\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e$$CON3=\\frac{\\left(I+P\\right)+R+O}{\\left(I+P\\right)+R+O+NC}$$\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Equation\" id=\"Equb\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Equb\" name=\"EquationSource\"\u003e$$RR5= \\frac{I}{\\left(I+P\\right)+\\left(R+NC+O\\right)}$$\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Equation\" id=\"Equc\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Equc\" name=\"EquationSource\"\u003e$$RR6= \\frac{I+P}{\\left(I+P\\right)+\\left(R+NC+O\\right)}$$\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Equation\" id=\"Equd\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Equd\" name=\"EquationSource\"\u003e$$COOP1=\\frac{I}{\\left(I+P\\right)+R+O}$$\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Equation\" id=\"Eque\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Eque\" name=\"EquationSource\"\u003e$$COOP2=\\frac{(I+P)}{\\left(I+P\\right)+R+O}$$\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Equation\" id=\"Equf\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Equf\" name=\"EquationSource\"\u003e$$REF3=\\frac{R}{\\left(I+P\\right)+\\left(R+NC+O\\right)}$$\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u003ctable border=\"1\" id=\"Tab1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCall Disposition Descriptions\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"2\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDisposition\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDescription\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eComplete\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eComplete interview designations required that participants answer the questions necessary for calculation of the bed net indicators of interest as well as those for poststratification adjustment (i.e., bicycle, TV, and radio ownership).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePartial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePartial interview designations only required that participants answer the questions necessary for calculation of the bed net indicators of interest, but not those used for poststratification adjustment.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBreakoff\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBreakoff interview designations denote those interviews in which a participant started answering questions, but ultimately broke off the call before a designation of complete or partial could be established.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRefusal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRefusals were characterized by respondents who indicated that they were not interested in participating in the survey.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon-contact\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon-contact interviews are those in which the participant could not be reached (no answer or non-assigned phone number).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIf an interview was designated as anything other than complete, partial, breakoff, or refusal, it was dispositioned as \u0026lsquo;other\u0026rsquo;. In most instances, a designation of \u0026lsquo;other\u0026rsquo; resulted from skipped questions necessary for a disposition of complete/partial, but in which the respondent finished the survey.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIneligible*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIneligible respondents are those who were under the age of 18 years or those whose call was ended as the sample quota had been reached for their region.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFinished*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFinished interviews was used as an internal program designation and was used to track progress towards sample size goals. This would include calls dispositioned as complete, partial, and other so long as the participant reached the end of the survey. As such, while this designation was used to track progress towards sample size goals, this category of interviews is not meaningful from an analytic perspective.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e*Not an official AAPOR disposition category: the AAPOR provides guidance on dispositioning calls but encourages researchers to establish a priori definitions of what constitutes a complete vs. a partial interview and what distinguishes a partial interview from a break-off. Otherwise, prescribed equations are provided for calculating rates (i.e., response, cooperation, refusal, and contact rates) using call dispositions. Note that regardless of call disposition status, the RBM-MERG bed net coverage indicators were calculated if the requisite data elements were available.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eBased on the call disposition categories described in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e, the number of finished interviews is higher than the number of complete/partial interviews, and complete interviews, being more restrictive in their designation, are a subset of partial interviews. All available data points were taken into consideration for calculation of each individual indicator of interest regardless of call disposition status, which resulted in differing sample sizes across indicators for the same regions.\u003c/p\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eData analysis.\u003c/span\u003e Unweighted/unadjusted estimates were calculated for all indicators of interest. Following the initial analysis, poststratification adjustment was used to weight regional bed net indicator estimates. The marginal proportions of radio, TV, and bicycle ownership as well as region were calculated from the 2017 MIS and corresponding attributes from the combined RDD/opt-in surveys were raked to these MIS marginal proportions. Including region in the raking process ensured poststratification adjustment by the necessary administrative unit. All values in the narrative component of the report present adjusted indicator estimates. Additionally, logistic regression analyses were run for the two household-level RBM-MERG indicators with survey approach (RDD vs opt-in) as the outcome variable and household-level bed net indicator values used as predictor variables. Each regression controlled for region, radio and bicycle ownership, and household size.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 310,151 calls were placed to 246,233 unique phone numbers (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Of the total calls placed, 163,748 contacts were made (including refusals \u0026amp; breakoffs, partial/complete interviews, other classifications, and ineligible respondents \u0026ndash; see Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e for a description of call dispositions). Of the 163,748 contacts made, 6,968 participants made it to the end of the survey regardless of whether they answered each question along the way (i.e., they may have skipped certain questions, but still finished the survey). A total of 3,020 interviews were designated as complete, meaning all bed net indicators of interest for these respondents could be calculated and for which poststratification adjustment could be conducted. Interviews designated as \u0026lsquo;complete\u0026rsquo; were used to calculate overall response rate. The percent of finished interviews varied by region from 177% of target (Unguja region; n\u0026thinsp;=\u0026thinsp;443) to 48% of target (Pemba region; n\u0026thinsp;=\u0026thinsp;121).\u003c/p\u003e\n\u003cp\u003eThe response rate was approximately 1.5% across the combined RDD and opt-in survey methodologies. Because the opt-in method was expected to have fewer non-contact calls by virtue of the opt-in nature of the program, the cooperation rate, defined in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e, can be assessed to get an alternative indication of successful interviews as non-contacts are removed from the denominator. This metric was calculated at 2.7% for complete interviews. Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e also presents call characteristics by survey method (RDD and opt-in). Nearly one-quarter (24.9%) of calls placed to the opt-in group were designated as non-contacts. The cooperation rates between the two methods differed by about 0.8 percentage points in favor of the opt-in method. The average length of surveys with a call disposition of complete or partial was just under ten minutes.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u0026nbsp;\u003ctable border=\"1\" id=\"Tab2\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCall characteristics and AAPOR call disposition by method\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCalls\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCombined methods\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eRDD method only\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eOpt-in method only\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal calls placed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e310,151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e142,946\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e167,205\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal unique numbers called\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e246,233 (79.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e138,728 (97.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e107,505 (64.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCall disposition\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(NC) Non-contacts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82,485 (33.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55,673 (40.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26,812 (24.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(R) Refusals \u0026amp; break-offs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e127,375 (51.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74,741 (53.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52,634 (49.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(P) Partial interviews\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3,192 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1,551 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1,641 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(I) Completed interviews\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3,020 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1,462 (1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1,558 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(O) Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5,448 (2.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2,053 (1.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3,395 (3.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIneligible respondents\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27,733 (11.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4,710 (3.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23,023 (21.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAAPOR designations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eContact rate 3 (\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eCON3\u003c/span\u003e): (I\u0026thinsp;+\u0026thinsp;P)\u0026thinsp;+\u0026thinsp;R\u0026thinsp;+\u0026thinsp;O/(I\u0026thinsp;+\u0026thinsp;P)\u0026thinsp;+\u0026thinsp;R\u0026thinsp;+\u0026thinsp;NC\u0026thinsp;+\u0026thinsp;O\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eResponse rate 5 (\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eRR5\u003c/span\u003e): I/((I\u0026thinsp;+\u0026thinsp;P)+(R\u0026thinsp;+\u0026thinsp;NC\u0026thinsp;+\u0026thinsp;O))\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eResponse rate 6 (\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eRR6\u003c/span\u003e): (I\u0026thinsp;+\u0026thinsp;P)/((I\u0026thinsp;+\u0026thinsp;P)+(R\u0026thinsp;+\u0026thinsp;NC\u0026thinsp;+\u0026thinsp;O))\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCooperation rate 1 (\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eCOOP1\u003c/span\u003e): I/(I\u0026thinsp;+\u0026thinsp;P)\u0026thinsp;+\u0026thinsp;R\u0026thinsp;+\u0026thinsp;O)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCooperation rate 2 (\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eCOOP2\u003c/span\u003e): (I\u0026thinsp;+\u0026thinsp;P)/((I\u0026thinsp;+\u0026thinsp;P)\u0026thinsp;+\u0026thinsp;R\u0026thinsp;+\u0026thinsp;O))\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRefusal rate 3 (\u003cspan class=\"BoldItalic\" name=\"Emphasis\" type=\"BoldItalic\"\u003eR3\u003c/span\u003e): R/((I\u0026thinsp;+\u0026thinsp;P)+(R\u0026thinsp;+\u0026thinsp;NC\u0026thinsp;+\u0026thinsp;O))\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvey Details\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAverage survey length (I\u0026thinsp;+\u0026thinsp;P)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 min 51 sec\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 min 49 sec\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 min 52 sec\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\"\u003e\u003cem\u003eRDD\u003c/em\u003e random digit dial; \u003cem\u003eAAPOR\u003c/em\u003e: American Association of Public Opinion Research \u003cem\u003emin\u003c/em\u003e minutes; \u003cem\u003esec\u003c/em\u003e seconds\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\"\u003e\u0026dagger;Not an official AAPOR designation \u0026ndash; ineligible respondents were under the age of 18 years or were excluded from participation because their call exceeded the regional quota.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eBecause respondents could skip or refuse to answer any question, the desired sample size of 250 respondents per region was not achieved for all assessed indicators despite reaching 99.5% of the overall target of finished interviews (6,968 of 7,000). The indicator for households with at least one bed net of any type had at least 250 valid responses for all regions except for Pemba where the sample size was 213 households or 81.5% of the target. For the other two assessed RBM-MERG indicators (percent of households with at least one bed net of any type for every two people and percent of de facto household population with access to a bed net of any type within their household), the desired sample size of 250 households was not reached for Katavi, Lindi, Mtwara, Rukwa, and Pemba regions. Aside from Pemba, which only reached 48% of the target, each of the aforementioned regions was within approximately 75% of the target. \u003cstrong\u003eAdditional File 2\u003c/strong\u003e shows the number of observations available by region to calculate assessed indicators.\u003c/p\u003e\n\u003cp\u003eThe results for the three assessed RBM-MERG indicators are shown in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. Population access to a bed net varied from an adjusted low of 48.1% in Katavi region to an adjusted high of 65.5% in Dodoma region. The adjusted percent of households that had a least one bed net ranged from 54.8% (Pemba) to 75.5% (Dodoma); the adjusted percent of households with at least one bed net per 2 de facto household population ranged from 35.9% (Manyara) to 55.7% (Dodoma); and the de facto household population access to a bed net ranged from an adjusted percent of 48.1% (Katavi) to 65.5% (Dodoma). Unweighted estimates are generally lower than those produced from the poststratification process for households with at least one bed net. The average regional difference between the two estimations is +\u0026thinsp;2.6 percentage points for this indicator although six regions exceed a difference of +\u0026thinsp;5 percentage points. Three-quarters of the regional estimates for both households with at least one bed net per two de facto household population and population access to a bed net were within \u0026plusmn;\u0026thinsp;4 percentage points across the two estimates. Overall, adjusted regional estimates for households with at least one bed net per two de facto household population were generally lower than the unweighted estimates whereas the opposite is true of population access to a bed net. Additional non-RBM MERG indicators were also calculated including the percent of bed nets self-reported by survey respondents as purchased from an adjusted low of 18.9% (Songwe) to an adjusted high of 59.8% (Arusha) (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). The indicator for the percent of bed nets self-reported by survey respondents to have ever been treated with insecticide which ranged from an adjusted low of 24.0% (Ruvuma) to an adjusted high of 56.2% (Mbeya).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u0026nbsp;\u003ctable border=\"1\" id=\"Tab3\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eUnweighted and adjusted RBM-MERG bed net indicator estimates by region\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eHousehold has 1\u0026thinsp;+\u0026thinsp;bed net\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eHousehold has 1\u0026thinsp;+\u0026thinsp;bed net per\u003c/p\u003e\n \u003cp\u003e2 de facto population\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eDe facto population access to a bed net\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnweighted\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdjusted*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e% pt. diff.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnweighted\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdjusted*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e% pt. diff.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnweighted\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdjusted*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e% pt. diff.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMainland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.5 [64.6, 66.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.4 [67.1, 69.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.5 [49.4, 51.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.1 [46.5, 49.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.2 [55.0, 57.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.3 [55.6, 59.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eZanzibar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.0 [49.7, 56.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.4 [49.7, 61.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.4 [38.2, 46.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.8 [36.7, 51.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.9 [40.0, 49.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.1 [40.9, 57.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eArusha\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.1 [52.2, 60.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61.6 [55.4, 67.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.2 [33.8, 42.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.6 [30.0, 43.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.7 [43.9, 47.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.7 [41.8, 55.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDar es salaam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.9 [65.1, 72.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e70.4 [64.4, 76.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.9 [49.2, 58.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.4 [43.1, 57.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.3 [61.5, 65.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.0 [53.9, 70.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDodoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69.8 [65.9, 73.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.5 [69.7, 81.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.1 [53.2, 62.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.7 [48.4, 63.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.4 [61.6, 65.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.5 [57.9, 73.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeita\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.9 [61.8, 70.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73.5 [67.7, 79.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.1 [43.9, 54.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.1 [38.8, 53.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.9 [53.0, 56.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.2 [47.0, 63.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIringa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.6 [68.9, 76.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78.4 [73.1, 83.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.0 [53.4, 62.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.4 [48.5, 62.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.1 [58.2, 62.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.9 [57.4, 72.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKagera\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.9 [65.0, 72.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67.9 [62.0, 73.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.2 [47.4, 57.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.2 [42.1, 56.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.4 [57.4, 61.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.9 [52.2, 67.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKatavi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.0 [54.4, 65.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.9 [48.1, 65.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.0 [39.8, 54.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.6 [35.7, 57.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.1 [48.4, 53.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.1 [36.9, 59.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKigoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.0 [58.5, 67.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e70.4 [63.8, 77.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.1 [43.2, 55.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.5 [44.2, 60.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.7 [53.4, 58.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.2 [54.0, 70.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKilimanjaro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.8 [56.7, 65.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.5 [58.3, 70.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.8 [40.0, 49.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.2 [33.3, 47.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.4 [46.4, 50.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.3 [43.1, 57.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLindi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67.0 [61.8, 72.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.6 [60.3, 77.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.7 [48.8, 62.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.6 [44.7, 66.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61.3 [58.9, 63.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.7 [48.3, 73.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eManyara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.2 [55.2, 65.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.1 [51.9, 68.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.8 [40.7, 53.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.9 [26.6, 45.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-10.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.3 [48.0, 52.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.1 [40.1, 62.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e69.8 [65.5, 74.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71.7 [65.8, 77.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.8 [41.6, 52.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.7 [32.8, 46.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.8 [55.9, 59.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.4 [49.5, 63.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMbeya\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67.8 [63.7, 71.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73.1 [66.9, 79.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.8 [49.0, 58.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.0 [43.3, 58.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.8 [53.8, 57.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.0 [48.8, 65.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMorogoro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.6 [60.5, 68.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.1 [58.7, 71.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.8 [48.6, 58.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.2 [47.3, 63.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.9 [56.8, 60.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.9 [47.3, 66.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMtwara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.0 [58.4, 69.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.5 [59.8, 77.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.2 [42.1, 56.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.4 [41.5, 63.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.4 [48.6, 54.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.6 [45.1, 68.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMwanza\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.4 [64.7, 72.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.1 [66.6, 77.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.0 [48.4, 57.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.3 [48.6, 62.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.9 [59.1, 62.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.6 [56.2, 71.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNjombe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.7 [55.8, 65.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.0 [55.6, 70.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.0 [42.4, 53.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.4 [43.2, 59.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.6 [50.1, 55.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.2 [49.9, 68.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePwani\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.3 [67.8, 76.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76.3 [69.4, 83.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.9 [51.1, 62.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.9 [43.9, 61.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.7 [60.4, 65.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.2 [55.4, 73.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRukwa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.0 [56.8, 67.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.2 [54.3, 72.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.5 [39.9, 53.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.1 [35.1, 57.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.7 [47.2, 52.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.6 [45.7, 67.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRuvuma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.9 [64.8, 73.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.2 [66.1, 78.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.4 [48.2, 58.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.4 [43.0, 57.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.3 [56.2, 60.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.0 [51.8, 68.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShinyanga\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.4 [60.1, 68.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.3 [58.7, 71.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.7 [43.4, 54.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.5 [34.4, 50.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-6.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.2 [55.1, 59.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.4 [45.0, 61.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSimiyu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.2 [60.5, 69.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.0 [61.2, 74.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.8 [35.0, 46.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.8 [29.6, 45.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.3 [49.2, 53.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.8 [43.6, 59.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.3 [62.2, 70.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68.0 [61.3, 74.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.0 [47.8, 58.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.8 [42.7, 58.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.3 [54.4, 58.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.4 [48.2, 66.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSongwe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.4 [53.4, 63.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.2 [51.1, 67.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.3 [41.2, 53.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.1 [41.8, 60.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.2 [45.8, 50.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.0 [40.1, 61.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTabora\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.8 [59.7, 67.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67.0 [60.7, 73.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.2 [42.1, 52.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.4 [35.6, 51.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57.2 [55.3, 59.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.1 [51.1, 67.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTanga\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.7 [62.6, 70.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.2 [59.5, 72.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.8 [50.7, 61.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.3 [47.2, 63.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.6 [57.7, 61.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.6 [50.4, 68.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePemba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.9 [49.2, 62.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.8 [43.2, 66.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.5 [36.6, 54.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.4 [33.6, 63.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54.6 [51.3, 58.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.3 [33.2, 67.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnguja\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.1 [48.4, 55.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.6 [49.1, 62.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.5 [36.7, 46.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.6 [34.4, 50.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.9 [40.1, 43.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.8 [39.6, 58.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\"\u003e\u0026dagger;Calculated from all available data points regardless of the presence of values for variables used in the poststratification process.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\"\u003e*Only records with available data points for poststratification adjustment could be used to produced adjusted estimates. As such, adjusted estimates are calculated from a truncated data set compared to the data set used to calculate the unweighted estimates.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\"\u003e\u003cem\u003eCI\u003c/em\u003e confidence interval;\u0026nbsp;\u003cem\u003e% pt. diff.\u003c/em\u003e percentage point difference\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u0026nbsp;\u003ctable border=\"1\" id=\"Tab4\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eNon-RBM-MERG bed net indicators by region\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eBed nets self-reported as purchased\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eBed nets self-reported as originally or ever treated with insecticide\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnweighted\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdjusted*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e% pt. diff.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnweighted\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdjusted*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e% pt. diff.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e% [95% CI]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMainland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.4 [36.8, 39.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.9 [36.8, 41.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.3 [40.6, 43.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.6 [36.2, 41.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eZanzibar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.1 [33.0, 47.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.8 [35.6, 58.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.1 [34.4, 47.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.8 [32.3, 53.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eArusha\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.4 [48.5, 54.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.8 [50.5, 69.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.0 [34.2, 39.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.1 [21.5, 40.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDar es salaam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.5 [45.9, 51.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.6 [42.5, 62.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.6 [38.1, 43.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.0 [27.2, 46.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDodoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.4 [35.7, 41.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.9 [31.2, 50.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.3 [46.5, 52.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.9 [38.2, 61.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeita\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.2 [31.5, 37.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.3 [26.0, 42.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.3 [38.4, 44.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.1 [22.6, 41.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIringa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.2 [32.6, 37.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.5 [23.3, 39.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.0 [50.3, 55.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.2 [44.3, 66.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKagera\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.1 [21.8, 26.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25.6 [17.6, 33.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.9 [32.2, 37.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.1 [18.4, 37.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKatavi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.0 [38.2, 45.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.4 [39.4, 67.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;11.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.9 [34.1, 41.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.8 [13.2, 44.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKigoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.9 [30.8, 37.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.4 [30.2, 54.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.0 [36.8, 43.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.5 [28.5, 52.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKilimanjaro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.2 [36.3, 42.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.0 [26.0, 46.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.9 [45.9, 51.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.7 [24.1, 43.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-15.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLindi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.0 [43.7, 50.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.6 [35.6, 61.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.2 [42.0, 48.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.2 [31.4, 61.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eManyara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.7 [33.4, 39.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.4 [24.1, 50.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.2 [43.0, 49.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.3 [22.6, 55.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.7 [37.9, 43.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.1 [29.7, 48.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.8 [42.9, 48.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.4 [36.4, 56.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMbeya\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.8 [28.9, 34.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.1 [30.5, 47.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.2 [44.0, 50.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.2 [45.8, 66.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMorogoro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.9 [44.1, 49.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.8 [33.9, 57.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.2 [40.5, 45.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.8 [29.6, 54.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMtwara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.5 [35.7, 43.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.1 [29.7, 58.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.7 [38.1, 45.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.8 [24.2, 55.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMwanza\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.8 [31.5, 36.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.7 [23.3, 38.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.1 [35.6, 40.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.5 [26.3, 44.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNjombe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.9 [29.5, 36.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.8 [22.8, 42.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.5 [36.8, 44.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.6 [28.7, 56.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePwani\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46.9 [43.7, 50.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.6 [39.3, 63.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.1 [39.9, 46.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.2 [20.8, 45.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRukwa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.3 [30.0, 36.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.9 [21.9, 43.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.4 [32.0, 38.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.8 [23.3, 54.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRuvuma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.5 [38.5, 44.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.5 [29.0, 49.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.8 [30.0, 35.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.0 [15.7, 32.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShinyanga\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.1 [42.2, 48.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.8 [37.3, 60.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.8 [31.1, 36.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.8 [23.4, 44.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSimiyu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.9 [36.5, 43.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.6 [28.5, 50.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.7 [37.7, 43.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.4 [25.9, 48.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSingida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.9 [33.3, 38.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.5 [20.5, 40.6]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.4 [42.6, 48.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.2 [25.7, 52.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-6.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSongwe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.0 [21.2, 26.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.9 [10.5, 27.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.0 [35.8, 42.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.3 [24.6, 53.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTabora\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.7 [33.3, 38.2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.9 [28.9, 46.8]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.3 [42.7, 47.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38.7 [27.6, 49.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTanga\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.7 [37.0, 42.3]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.7 [30.9, 54.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53.8 [51.1, 56.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43.6 [31.8, 55.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePemba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.6 [35.5, 43.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.1 [26.8, 71.4]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.8 [38.7, 46.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.0 [15.9, 56.0]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnguja\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.3 [37.6, 42.9]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.7 [33.0, 58.5]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40.6 [38.0, 43.1]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.6 [33.4, 57.7]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\u0026dagger;Calculated from all available data points regardless of the presence of values for variables used in the poststratification process.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e*Only records with available data points for poststratification adjustment could be used to produced adjusted estimates. As such, adjusted estimates are calculated from a truncated data set compared to the data set used to calculate the raw and unweighted estimates.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\"\u003e\u003cem\u003eCI\u003c/em\u003e confidence interval;\u0026nbsp;\u003cem\u003e% pt. diff.\u003c/em\u003e percentage point difference\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e presents the results of the secondary objective of the study: the comparison of a true RDD approach to that of an opt-in approach.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u0026nbsp;\u003ctable border=\"1\" id=\"Tab5\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eRDD vs opt-in method of calling: logistic regression analysis results\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eOdds Ratio [95% CI]\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHousehold has 1\u0026thinsp;+\u0026thinsp;bed net (of any type)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e*1.18 [1.03, 1.36]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHousehold has 1\u0026thinsp;+\u0026thinsp;ITN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.06 [0.93, 1.21]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHousehold has 1\u0026thinsp;+\u0026thinsp;bed net (of any type) per 2 de facto\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e***1.26 [1.12, 1.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHousehold has 1\u0026thinsp;+\u0026thinsp;ITN per 2 de facto\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.06 [0.91, 1.25]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003eEach logistic regression controlled for region, radio ownership, bike ownership, and household size. In each logistic regression equation, the opt-in method was set as the reference category. Observation counts exceeded 4,000 for each regression analysis.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e* p\u0026thinsp;\u0026lt;\u0026thinsp;0.05; ** p\u0026thinsp;\u0026lt;\u0026thinsp;0.01; *** p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\u003cem\u003eRDD\u003c/em\u003e random digit dial; \u003cem\u003eCI\u003c/em\u003e confidence interval; \u003cem\u003eITN\u003c/em\u003e insecticide-treated bed net\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe difference in the RDD and opt-in method of calling respondents was significant at an alpha level of 0.05 for the indicators of households with at least 1 bed net (of any type) and households with at least 1 bed net (of any type) per 2 de facto household population. Assuming a national RDD base rate prevalence of 50% for households with at least 1 bed net, the corresponding prevalence for the national opt-in method is estimated to be 54.1% given an odds ratio of 1.18. Likewise, the indicator of household ownership of at least 1 bed net (of any type) per 2 de facto household population showed a significant difference between the two survey approaches and was associated with an odds ratio of 1.26. This is roughly consistent with a national RDD estimate of 50% prevalence corresponding to a national opt-in estimate of 55.8% prevalence. No significant differences between the two survey approaches were noted when assessing these same two indicators restricted to only ITN availability.\u003c/p\u003e\n"},{"header":"Discussion","content":"\u003cp\u003eThe NMCP and ZAMEP have an established threshold of \u0026ge;\u0026thinsp;80% de facto household population bed net access which constitutes an acceptable level of coverage. Bed net access levels below this threshold are likely to trigger additional ITN distribution response mechanisms. The results of the current study showed that no region met or exceeded the 80% threshold and in some regions the coverage estimates were rather low (~\u0026thinsp;50% in eight regions) indicating an urgent need to ensure that additional ITNs are available. Indeed, the de facto household population access to a bed net ranged from an adjusted percent of 48.1% (Katavi) to 65.5% (Dodoma). Mobile phone survey estimates for the adjusted percent of households with at least one bed net per 2 de facto household population were also relatively low with 46.4% (16 of 28) of regions below 50%. However, nearly one-third (10 of 28; 35.7%) of regions were estimated to have at least 70% coverage of households with at least one bed net. The challenges of achieving and maintaining net access above 80% are significant, given the rates at which bed nets are lost to wear and tear and the challenges of reaching all households with sufficient bed nets when they need them (30, 31).\u003c/p\u003e \u003cp\u003eThe mobile phone survey used for this study employed two different methods to sample respondents. First, a standard RDD approach in which truly random numbers were dialed and secondly, an opt-in-based approach in which a set of pre-identified, opt-in participant phone numbers were sampled for dialing. The estimates produced by both approaches were generally similar. However, the opt-in approach achieved the sample size targets more rapidly and in a wider range of regions of the country including among smaller and more sparsely populated regions. The dual sampling strategy allowed for an assessment of the relative bias of the RDD versus the opt-in approach with respect to household-level bed net coverage indicators. This assessment showed that, while significant, differences between the two survey methodologies were small and would likely not have a programmatically meaningful impact (see caption of Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Nationally, the two household-level bed net indicators were estimated to be within 5 percentage points by either sampling strategy. The magnitude of this difference is not likely to greatly alter the decision-making process.\u003c/p\u003e \u003cp\u003eOne explanation for the particularly low bed net coverage estimates noted for several regions may be attributable to the 2020 mass replacement campaign (MRC) conducted for mainland Tanzania. In 10 of the regions selected for the MRC, only certain districts received bed nets. As such, coverage estimates for these 10 regions may be lower than anticipated as this survey includes districts which did not receive replacement bed nets in 2020. For example, only two of Kilimanjaro\u0026rsquo;s seven districts were targeted for the 2020 MRC, while survey respondents may have resided anywhere within the region, potentially underestimating the overall coverage of Kilimanjaro. Similarly, two of six councils in Njombe and two out of seven councils in Manyara were targeted for the 2020 MRC, the latter of which experienced ongoing distribution at the time of the survey.\u003c/p\u003e \u003cp\u003eResponse rates for RDD IVR surveys are typically low, and it is common for breakoffs to occur quickly after successful contacts are made. A previous RDD mobile phone survey was conducted in Tanzania immediately following the 2017 MIS (unpublished data) which achieved a response rate (RR5) of 5.8% compared to the overall RR5 of 1.5% for the current survey. As an additional point of reference, a 2017 RDD IVR study conducted in Ghana reported achieving a response rate of 21% (32). The low response rates noted for the current study (RR5 of 1.1% and 1.8% for the RDD and opt-in methods, respectively) may be due to an increase in RDD IVR surveys in Tanzania as a precaution against exposing survey enumerators to COVID-19. The overall increase in such mobile phone surveys may lead to respondent fatigue. In addition, in the context of COVID-19, respondents may be preoccupied with other concerns and therefore less likely to respond. Opt-in respondents were collectively expected to demonstrate a higher response rate than participants from the RDD sampling pool, but, surprisingly, their RR5 metric was only slightly higher. The potential benefits from the opt-in approach are shorter call times for those individuals completing the survey due to truncated cascade-style questions on location of residence as well as more willing participants (i.e., a higher response rate) compared to the true RDD approach. Indeed, the opt-in sampling strategy made 31,223 fewer calls than the RDD method but yielded about 100 additional completed surveys.\u003c/p\u003e \u003cp\u003eIn general, non-coverage and non-response biases are potential issues when conducting mobile phone surveys in LMIC. As mobile phone penetration continues to increase across certain LMIC, however, non-coverage bias is gradually reduced (33, 34). Nevertheless, evidence from recent studies show that MPS tend to oversample male, urban, younger, and better educated respondents \u0026ndash; all of whom are generally more likely to own mobile phones in LMIC settings suggesting that non-coverage bias remains an issue (16, 32, 35, 36). Mobile phone surveys also tend to underrepresent women in Africa, although it remains unclear the extent to which this underrepresentation reflects non-coverage bias or non-response bias (32, 37). The potential bias in participant type may lead to differential responses to questions concerning the general health and well-being of family members including report on protective measures such as availability and use of bed nets.\u003c/p\u003e \u003cp\u003eThe mobile phone survey questionnaire used for this research asked questions related to bed net use for pregnant women and children under five, but the sample size calculation was structured on household ownership of at least one net and did not factor in whether that household would have had members from these higher-risk groups. As such, few data points for these populations were available and calculation of net use indicators was not conducted. Sample size requirements for these target groups are likely to be too large to pragmatically conduct the mobile phone survey given general budget and time considerations.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eMobile phone surveys can provide rapid estimates of bed net coverage in Tanzania and may serve as a suitable source of information between large-scale household surveys. The veracity of estimates obtained from mobile phone surveys can be validated against household survey estimates, particularly if they are conducted contemporaneously. Based on the results generated by this survey, overall bed net access in the country appears to be lower than target thresholds, with some regions being especially low. The results suggest that bed net distribution is needed in large sections of the country to ensure that access levels remain high enough (above 80%) to permit high levels of bed net use and sustain protection of the population. Lastly, mobile phone survey sampling methodologies based on pre-existing, opt-in respondent lists may be a more efficient and simpler way to collect bed net coverage data compared to RDD methods.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cem\u003eDHS\u003c/em\u003e Demographic and Health Surveys; \u003cem\u003eMIS\u003c/em\u003e Malaria Indicator Survey; \u003cem\u003eNMCP\u003c/em\u003e National Malaria Control Program; \u003cem\u003eZAMEP\u003c/em\u003e Zanzibar Malaria Elimination Program; \u003cem\u003eITN\u003c/em\u003e Insecticide-treated bed net; \u003cem\u003eLMIC\u003c/em\u003e Low- and middle-income countries; \u003cem\u003eIVR\u003c/em\u003e Interactive voice response; \u003cem\u003eRDD\u003c/em\u003e Random digit dial; \u003cem\u003eRBM-MERG\u003c/em\u003e Roll Back Malaria Partnership to End Malaria-Monitoring and Evaluation Reference Group; \u003cem\u003eAAPOR\u003c/em\u003e American Association for Public Opinion Research; \u003cem\u003eMRC\u003c/em\u003e Mass replacement campaign\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll research activities conformed to the Declaration of Helsinki (38). Ethical approval to conduct the study was received from the Tanzania National Institute for Medical Research (Ref. NIMR/HQ/R.8a/Vol. IX/3473). Participant consent was obtained from an affirmative response to a pre-recorded message that read out a short consent script at the beginning of the mobile phone survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe permission to publish the findings was obtained from NIMR with approval number NIMR/HQ/P.12 VOL XXXIII/132\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the President\u0026rsquo;s Malaria Initiative (PMI) under the terms of USAID/JHU Contract number 72062120C00001. The contents do not necessarily reflect the views of PMI or the United States Government.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMW, BK, JY, FC, SL, CD, SA, RI, MK, PG, DM, HM, SD, DD, NS, DL, and HK assisted in the design of the study, MW conducted the analysis and drafted the manuscript. MW, BK, JY, FC, SL, CD, SA, RI, MK, PG, DM, HM, SD, DD, NS, DL, and HK reviewed and approved the final manuscript.\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003e\u003cspan\u003eWorld Health Organization. World Malaria Report 2020. Geneva, Switzerland: World Health Organization: Geneva: World Health Organization; 2020.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eOrganization WH. World malaria report 2020: 20 years of global progress and challenges. Geneva; 2020.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eMinistry of Health CD, Gender E and C (MoHCDGEC) [Tanzania M, Ministry of Health (MoH) [Zanzibar], Tanzania NB of S (NBS), Office of the Chief Government Statistician (OCGS), ICF,. Tanzania Malaria Indicator Survey 2017. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF; 2017.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eMinistry of Health CD, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF,. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF; 2016.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eTanzania Commission for AIDS (TACAIDS) ZACZ, National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and Macro International Inc,. Tanzania HIV/AIDS and Malaria Indicator Survey 2007-08. Dar es Salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and Macro International Inc.; 2008.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eTanzania Commission for AIDS (TACAIDS) ZACZ, National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF International,. Tanzania HIV/AIDS and Malaria Indicator Survey 2011-12. Dar es Salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and ICF International; 2013.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eBhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526(7572):207\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eThe United Republic of Tanzania. Tanzania National Strategy for Vector Control, 2019\u0026ndash;2024. Ministry of Health, Community Development, Gender, Elderly and Children: Ministry of Health, Community Development, Gender, Elderly and Children; 2019.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eKilian A, Obi E, Mansiangi P, Ab\u0026iacute;lio AP, Haji KA, Blaufuss S, et al. Variation of physical durability between LLIN products and net use environments: summary of findings from four African countries. Malaria Journal. 2021;20(1):26.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eAday LA, Cornelious LJ. Designing and conducting health surveys. Third Edition ed: Wiley; 2011.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eEvaluation M. Report of a Technical Meeting on the Use of Lot Quality Assurance Sampling (LQAS) in Polio Eradication Programs. Chapel Hill, NC: Carolina Population Center University of North Carolina; 1998.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eHoshaw-Woodard S. Description and comparison of the methods of cluster sampling and lot quality assurance sampling to assess immunization coverage. Geneva: World Health Organization; 2001.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eSingh J, Jain DC, Sharma RS, Verghese T. Evaluation of immunization coverage by lot quality assurance sampling compared with 30-cluster sampling in a primary health centre in India. Bull World Health Organ. 1996;74(3):269\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eVanamail P, Subramanian S, Srividya A, Ravi R, Krishnamoorthy K, Das PK. Operational feasibility of lot quality assurance sampling (LQAS) as a tool in routine process monitoring of filariasis control programmes. Trop Med Int Health. 2006;11(8):1256\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eMinges M. Mobile cellular communications in the Southern African region. Telecomm Policy. 1999;23:585\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eGMSA Intelligence. The Mobile Economy - Sub-Saharan Africa 2014. 2014.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eCastells M, Qui JL, Fernandez-Ardevol M, Sey A. Mobile Communication and Society: A Global Perspective. Cambridge, MA: MIT Press; 2009.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eAme AM, Jacob S. Relationship between network coverage and teledensity growth - case of giant telecommunication companies of Tanzania. International Journal of Management, IT and Engineering. 2013;3(5).\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eBank W. Information and Communications for Development: Maximizing Mobile. Washington, DC: World Bank; 2012.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eBallivian A, Azevedo JP, Durbin W. Using Mobile Phones for High-Frequency Data Collection. In: Toninelli, D, Pinter, R \u0026amp; de Pedraza, P (eds.) Mobile Research Methods: Opportunities and Challenges of Mobile Research Methodologies: London: Ubiquity Press. DOI: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.5334/bar.c\u003c/span\u003e\u003c/span\u003e. License: CC-BY 4.0; 2015.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eCroke K, Dabalen A, Demombynes G, Giugale M, Hoogeveen J. Collecting High Frequency Panel Data in Africa Using Mobile Phone Interviews. In: The World Bank PRaEMU, Africa Region,, editor. 2012.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eGibson DG, Pereira A, Farrenkopf BA, Labrique AB, Pariyo GW, Hyder AA. Mobile Phone Surveys for Collecting Population-Level Estimates in Low- and Middle-Income Countries: A Literature Review. J Med Internet Res. 2017;19(5):e139.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eHyder AA, Wosu AC, Gibson DG, Labrique AB, Ali J, Pariyo GW. Noncommunicable Disease Risk Factors and Mobile Phones: A Proposed Research Agenda. J Med Internet Res. 2017;19(5):e133.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eMahfoud Z, Ghandour L, Ghandour B, Mokdad AH, Sibai AM. Cell Phone and Face-to-face Interview Responses in Population-based Surveys. Field Methods. 2014;27(1):39\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eHu SS, Balluz L, Battaglia MP, Frankel MR. The impact of cell phones on public health surveillance. Bull World Health Organ. 2010;88(11):799.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eLabrique A, Blynn E, Ahmed S, Gibson D, Pariyo G, Hyder AA. Health Surveys Using Mobile Phones in Developing Countries: Automated Active Strata Monitoring and Other Statistical Considerations for Improving Precision and Reducing Biases. J Med Internet Res. 2017;19(5):e121.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eWorld Bank. World Development Report 2016: Digital Divides. Washington, DC: World Bank; 2016.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eMEASURE Evaluation, The Demographic and Health Surveys, The President\u0026apos;s Malaria Initiative, Roll Back Malaria Partnership, United Nations Children\u0026apos;s Fund, World Health Organization. Household Survey Indicators for Malaria Control. 2018.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eThe American Association for Public Opinion Research. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. 2016.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eBertozzi-Villa A, Bever CA, Koenker H, Weiss DJ, Vargas-Ruiz C, Nandi AK, et al. Maps and metrics of insecticide-treated net access, use, and nets-per-capita in Africa from 2000\u0026ndash;2020. Nature Communications. 2021;12(1):3589.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eKoenker H, Arnold F, Ba F, Cisse M, Diouf L, Eckert E, et al. Assessing whether universal coverage with insecticide-treated nets has been achieved: is the right indicator being used? Malaria Journal. 2018;17(1):355.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eL\u0026apos;Engle K, Sefa E, Adimazoya EA, Yartey E, Lenzi R, Tarpo C, et al. Survey research with a random digit dial national mobile phone sample in Ghana: Methods and sample quality. PLoS One. 2018;13(1):e0190902.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eLeo B, Morello R, Mellon J, Pieixoto T, Davenport S. Do mobile phone surveys work in poor countries? Washington, DC: Center for Global Development; 2015.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eTran MC, Labrique AB, Mehra S, Ali H, Shaikh S, Mitra M, et al. Analyzing the mobile \u0026quot;digital divide\u0026quot;: changing determinants of household phone ownership over time in rural bangladesh. JMIR Mhealth Uhealth. 2015;3(1):e24.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003ePew Research Center. Internet Connectivity Seen as Having Positive Impact on Life in Sub-Saharan Africa. 2018.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eRheault M, McCarthy J. Disparities in cellphone ownership pose challenges in Africa: Gallop World Poll; 2015 [December 7, 2021]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://news.gallup.com/poll/189269/disparities-cellphone-ownership-pose-challenges-africa.aspx\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eLau CQ, Lombaard A, Baker M, Eyerman J, Thalji L. How Representative Are SMS Surveys in Africa? Experimental Evidence From Four Countries. International Journal of Public Opinion Research. 2019;31(2):309\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003e\u003cspan\u003eWorld Medical Association. Ethics Unit. Declaration of Helsinki 2007 [Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"malaria-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"malj","sideBox":"Learn more about [Malaria Journal](http://malariajournal.biomedcentral.com/)","snPcode":"12936","submissionUrl":"https://submission.nature.com/new-submission/12936/3","title":"Malaria Journal","twitterHandle":"@malariajournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"ITN, mobile phone survey, random digit dial, coverage indicators, Tanzania","lastPublishedDoi":"10.21203/rs.3.rs-1689414/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1689414/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Monitoring and surveillance of bed net coverage indicators is critical, particularly due to threats in maintaining high population access to effective bed nets, but usually occurs every 2-3 years through large-scale national household surveys. However, the rapid growth of mobile phone ownership in Tanzania has resulted in mobile phone-based survey methodologies emerging as an alternative to household surveys.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A national mobile phone survey was conducted in early 2021 with focus on bed net ownership and access. Half of the sample target was contacted through a standard random digit dial methodology and the remaining half was reached through a voluntary opt-in respondent pool. Both sampling approaches used an interactive voice response survey conducted in Kiswahili.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The response rate was approximately 1.5% across the combined sampling approaches. Population access (i.e., the percent of the population that could sleep under a bed net, assuming one bed net per two people) varied from a regionally adjusted low of 48.1% (Katavi) to a high of 65.5% (Dodoma). The adjusted percent of households that had a least one bed net ranged from 54.8% (Pemba) to 75.5% (Dodoma); the adjusted percent of households with at least one bed net per 2 de facto household population ranged from 35.9% (Manyara) to 55.7% (Dodoma). The estimates produced by both sampling approaches were generally similar, differing by only a few percentage points. An analysis of differences between estimates generated from the two sampling approaches showed minimal bias when considering variation across the indicator for households with at least one bed net per two de facto household population.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Mobile phone surveys can provide rapid estimates of bed net coverage in Tanzania and may serve as a suitable source of information between large-scale household surveys. The results generated by this survey show that overall bed net access in the country appears to be lower than target thresholds. The results suggest that bed net distribution is needed in large sections of the country to ensure that coverage levels remain high enough to sustain protection against malaria for the population.\u003c/p\u003e","manuscriptTitle":"Estimation of bed net coverage indicators using a national mobile phone survey in Tanzania","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-05-31 16:32:04","doi":"10.21203/rs.3.rs-1689414/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2022-07-05T23:16:54+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"d321c52c-8759-4d14-9b36-01287bcaad36","date":"2022-06-20T17:19:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2022-06-08T00:38:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"15ccf324-99ea-4e04-ac29-996fec99dac9","date":"2022-06-07T19:11:48+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2022-06-07T06:17:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-05-27T14:00:23+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2022-05-27T14:00:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"Malaria Journal","date":"2022-05-24T15:16:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"malaria-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"malj","sideBox":"Learn more about [Malaria Journal](http://malariajournal.biomedcentral.com/)","snPcode":"12936","submissionUrl":"https://submission.nature.com/new-submission/12936/3","title":"Malaria Journal","twitterHandle":"@malariajournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9882a0ea-cd6e-43a5-97ec-a3bb5f508846","owner":[],"postedDate":"May 31st, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2022-12-05T10:59:32+00:00","versionOfRecord":[],"versionCreatedAt":"2022-05-31 16:32:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1689414","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1689414","identity":"rs-1689414","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}