Factors Associated with Indoor Residual Spraying Programme Effectiveness in Mutare City, Manicaland Province, Zimbabwe

Introduction: Malaria is a mosquito-borne disease causing fever, chills, and flu-like symptoms. If untreated, it can lead to severe complications and death (CDC, 2016). Recently, Mutare city recorded malaria cases after local transmission was confirmed in 2017. Indoor Residual Spraying (IRS) was implemented, but coverage decreased during the 2018/2019 IRS season, prompting a study in ten randomly selected locations. The study aimed to identify knowledge gaps, preferred alternatives to IRS, the influence of competing events, and household ownership on IRS. Methods: A descriptive cross-sectional study with 260 participants was conducted using proportional allocation for the study locations. Data were collected via interviewer-administered questionnaires, interviews with key informants, and focus group discussions. Results: Participants were mostly female (67%) and aged 31-60 years (50%), with vending being the top livelihood (52%). Only 38% always used bed nets, 24% owned houses, and 76% were tenants. IRS reservations included time consumption (11%), preference for other interventions (9%), landlord objections (22%), livelihood pressures (14%), labour intensity (15%), exposure of secrets and poverty (12%), distrust of the team (8%), and property damage (9%). Bed nets were preferred over IRS. Conclusion: Challenges in conducting IRS included knowledge gaps needing health education sessions, which faced attendance issues due to competing events. More strategic health education and bed net deployment were recommended.