Despite existence of effective tools for malaria control, malaria continues to be one of the
leading killer diseases especially among under-five year children and pregnant women in poor rural
populations of Sub Saharan Africa. In Tanzania Mainland the disease contributes to 39.4% of the total
OPD attendances. In terms of mortality, malaria is known to be responsible for more than one third of
deaths among children of age below 5 years and also contributes for up to one fifth of deaths among
pregnant women. This paper is based on a study conducted in a rural community along the shores of
Lake Victoria in Mwanza region, North-Western Tanzania. The study explores reasons for scepticism
and low uptake of insecticide treated mosquito nets (ITNs) that were promoted through social
marketing strategy for malaria control prior to the introduction of long lasting nets (LLN). The paper
breaks from traditional approach that tend to study low uptake of health interventions in terms of
structural practical constraints – cost, accessibility, everyday priorities – or in terms of cognition –
insufficient knowledge of benefits e.g. ignorance of public health messages. This paper has shown
that, the majority of people who could afford the prices of ITNs and who knew where to obtain the
insecticides did not necessarily buy them. This suggests that, although people tend to report costrelated
factors as a barrier against the use of ITNs, there are other critical concerns at work. Without
underestimating the practical factors, our study have recommended to consider critical examinations
of those other concerns that hinder optimal utilization of ITN for malaria control, and the basis for
those concerns.