D o m in a A s in g iz w e D o m in a A s in g iz w e C i t i z e n s c i e n c e f o r m a l a r i a c o n t r o l i n R w a n d a General introduction 9 Malaria in Rwanda Encouraged by the progress made in the reduction of malaria over the last decade, Rwanda planned to achieve the malaria pre-elimination phase by 2018 (President's Malaria Initiative, 2015). However, since 2012, Rwanda experienced a remarkable increase in malaria incidence that was reported across the country, especially in the eastern and southern regions, and this caused a great concern (MoH, 2017a; President's Malaria Initiative, 2016). A malariometric survey conducted in 2013 in the eastern part of Rwanda revealed a prevalence of malaria parasitemia of around 6% (Kateera, Mens, et al., 2015). Malaria prevalence continued to increase as time progressed. A Rwanda malaria indicator survey conducted in 2017 indicated 10 Malaria control measures Long-Lasting Insecticidal Nets (LLINs), Indoor Residual Spraying (IRS), and control of mosquito breeding sites are the primary measures that have been used to control malaria in many malaria-endemic countries including Rwanda. Globally, 80% of insecticide-treated mosquito nets (ITNs) (the first generation mosquito nets) delivered by manufacturers, were distributed through mass distribution campaigns, and 87% of the total ITNs produced in 2018, were distributed to Sub-Saharan African countries (WHO, 2019). In 2006 Rwanda had the first mass campaign distribution of LLINs (the next generation mosquito nets) targeting pregnant women and children under five years of age (MoH & (NISR), 2009). Since then, the President's Malaria Initiative (PMI) has collaborated with the National Malaria Control Program (NMCP) and the Global Fund to continue the procurement and distribution of LLINs to achieve universal coverage as recommended by the World Health Organization (President's Malaria Initiative, 2017). The Rwanda Ministry of Health reported that between December 2016 and March 2017, more than 5 million LLINs were distributed countrywide (MoH, 2017a). Generally, in 2019 only half (50%) of people at risk of malaria in Sub Saharan Africa slept under LLINs, and only 57% of the population had access to LLINs; this remains far from the target of universal coverage (WHO, 2019). In the same line, the recent Rwanda malaria indicator survey report indicated that 84% of households own at least one LLIN, and 72% have access to LLINs, meaning that 72% have enough LLINs (one for two people) (MOH, 2017b). However, 64% of the households visited slept under an LLIN the night before the survey, this indicates a gap between the accessibility and use; as well as between ownership and use of LLINs (MOH, 2017b). Different authors have explored the factors associated with the use of LLINs. Babalola et al. (2018) reported factors including sociodemographic and household variables, and psychosocial variables to be associated with using a bed net every night rather than rarely or never using a bed net. Although the protective effect of LLIN...