Factors associated with caregivers’ consistency of use of bed nets in Nigeria: a multilevel multinomial analysis of survey data

Abstract

BackgroundMalaria remains endemic in Nigeria despite programmes and policies put in place toward malaria elimination. Long-lasting insecticidal nets have been documented to offer protection from malaria by preventing mosquito bites. While many studies have examined the factors associated with the use of bed nets in Nigeria and across Africa, little information is available on the factors associated with consistency of use of bed nets.MethodsThe data for this study were derived from a household survey conducted in three states in Nigeria (Akwa Ibom, Kebbi and Nasarawa) between July and September 2015 by the Health Communication Capacity Collaborative, a 5-year cooperative agreement supported by the United States Agency for International Development and the US President’s Malaria initiative and led by the Johns Hopkins Center for Communication Programs. The analysis was limited to a total of 3884 men and women selected from 2863 households with at least one bed net. Multilevel multinomial logistic regression was used to assess the factors associated with consistency of use of bed nets.ResultsThe findings revealed 43.2% of the respondents use bed nets every night, while 38.4% use bed nets most nights. The factors associated with using a bed net every night rather than rarely or never using a bed net included sociodemographic and household variables (age, gender, religion, household size, net density, and household wealth), ideational variables (perceptions about severity, susceptibility, self-efficacy to use nets, and response-efficacy of bed net; awareness of place of purchase; willingness to pay for bed nets; attitudes towards net use; and descriptive norm about nets), and state of residence. The three study states differ significantly in terms of most of the independent variables included in the estimated model.ConclusionsThe study recommends that efforts designed to promote consistent use of bed nets should be state-specific and include strategies targeting ideational variables. Furthermore, given the significance of unmeasured heterogeneity at the cluster level, strategies to engage and mobilize the community, such as community dialogue, home visits and engaging community leadership, are relevant.

Individual and contextual correlates of mosquito net use among women in Nigeria

“…Since 2011, about 24 million nets have been provided free of charge in the country [9]. Despite these efforts at promoting net use and the resources committed to the programme, less than half of the women in the country use mosquito nets [10].…”

“…Attempts have been made by researchers to examine the factors influencing mosquito net use among women or caregivers that possessed mosquito nets. Some of the factors attributed to this include age, education, household wealth [11][12][13], household size, distance to health facility, ideational factors [10,14,15], knowledge about efficacy of mosquito nets to prevent malaria, source of knowledge of mosquito nets and socioeconomic class [16,17]. Only few of these studies considered the effects of contextual factors on mosquito net use.…”

Citizen science for malaria control in Rwanda : Engagement, motivation, and behaviour change

“…Other studies reported IRS refusal and failing to remove stagnant water bodies (Ingabire et al, 2015;Kaufman et al, 2012;Munguambe et al, 2011). From these studies, there are indications that the use of malaria preventive measures is partly determined by the perception of the risk of malaria infection and the effectiveness of these measures, by the increased prevalence of insects in the house after spraying, and by throwing LLINs away once they become dirty or torn out (Babalola et al, 2018;Birhanu et al, 2015;Hung et al, 2014;Ingabire et al, 2015;Kaufman et al, 2012;Munguambe et al, 2011;Watanabe et al, 2014).…”

“…Only few studies assessed the determinants of consistent bed net use (Babalola et al, 2018;Koenker et al, 2013), and as of yet, there is no evidence of the extent to which the identified determinants affect the intentions to use malaria preventive measures consistently, how important they are and how they can be influenced. In addition, a study using an integrated model of determinants of malaria preventive behaviour that maps the association between these perceptions and intentions to use these preventive measures is lacking.…”

“…People who do not perceive themselves to be at risk of having malaria are less likely to adopt these measures even if they own them (Ankomah et al, 2012). water, then many people in that community may intend to follow the apparent social norm and may plan to consistently do the same (Babalola et al, 2018). Thus, subjective norms and behavioural intentions are expected to have a positive relationship (Figure 3.1).…”