However, the study has revealed that simple changes could do a lot in boosting the project's effectiveness.
Insecticide treated nets have been shown to reduce childhood mortality by 17 percent in different areas in Africa, reduce infection with malaria parasites in pregnant women by 38 percent, and decrease the incidence of severe malarial anemia by 47 percent.
The study by researchers from the London School of Hygiene and Tropical Medicine in London, England and the Ifakara Health Institute, Dar es Salaam, Tanzania looked at a sample of 6198 households that participated in the Tanzanian National Voucher Scheme between 2005 and 2007.
The program targets pregnant women and infants by providing vouchers for nets to women at their first antenatal visit.
However, the several simple steps involved in the program result in some attrition at each step, which causes a lower success rate than desired.
The researchers suggest that process analysis is useful to identify how programmes can be improved.
Nets pre-treated with insecticide are now being delivered, rather than relying on the recipients to treat the nets.
The study has been published in CMAJ (Canadian Medical Association Journal).