Socio-economic and demographic disparities in ownership and use of insecticide-treated bed nets for preventing malaria among rural reproductive-aged women in northern Ghana

Abstract

BackgroundMalaria continues to be a leading cause of morbidity and mortality in most countries in Sub-Saharan Africa. Insecticide-treated bed nets (ITNs) is one of the cost-effective interventions for preventing malaria in endemic settings. Ghana has made tremendous efforts to ensure widespread ownership and use of ITNs. However, national coverage statistics can mask important inequities that demand targeted attention. This study assesses the disparities in ownership and utilization of ITNs among reproductive-aged women in a rural impoverished setting of Ghana.MethodsPopulation-based cross-sectional data of 3,993 women between the age of 15 and 49 years were collected in seven districts of the Upper East region of Ghana using a two-stage cluster sampling approach. Bivariate and multivariate regression models were used to assess the social, economic and demographic disparities in ownership and utilization of ITN and to compare utilization rates among women in households owning at least one ITN.ResultsAs high as 79% of respondents were found to own ITN while 62% of ITN owners used them the night preceding the survey. We identified disparities in both ownership and utilization of ITNs in wealth index, occupational status, religion, and district of residence. Respondents in the relative richest wealth quintile were 74% more likely to own ITNs compared to those in the poorest quintile (p-value< 0.001, CI = 1.29–2.34) however, they were 33% less likely to use ITNs compared to the poorest (p-value = 0.01, CI = 0.50–0.91).ConclusionInterventions aimed at preventing and controlling malaria through the use of bed nets in rural Ghana and other similar settings should give more attention to disadvantage populations such as the poor and unemployed. Tailored massages and educational campaigns are required to ensure consistent use of treated bed nets.

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

“…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.…”

Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach

“…Even though LLIN deployment has been reported to be one of the most e cient packages that can lead to a 75% reduction in disease in much of Africa [62], Averting more predicted cases through LLINs may only be possible by stepping up the campaign to persuade the population to comply with proper LLIN usage while continuous efforts are made to sustain the already achieved coverage. Many factors have been reported for people not sleeping in ITN/LLIN including an inability to hang them, real or perceived health concerns, di culty in breathing when sleeping under them and other factors [63][64][65].…”

“…Given the possible high levels of LLIN non-use in Ghana, 58.0% ( 2016 ), which is relatively higher compared to her neighbours, Benin 28.9% ( 2017 ), Burkina Faso 33.0% ( 2014 ) and Cote d'Ivoire, 49.6% (2016), the community health o cers stationed in the various Community-Based Health Planning Services ( CHPS ) zones may be of great resource to undertaking these additional tasks of educating and mounting hang up campaigns and other means of communication to improve the usage of LLINs [61,[76][77][78].…”

Previous Trend, Present Prevalence and Integrated Knowledge, Attitude and Practice Towards Malaria and Use of Insecticide-treated Mosquito Net in the Rural Setting of Welkait District, Northwest Ethiopia

“…The main determinants in the ownership and utilization of ITNs as reviewed by Singh et al [18] educational level, knowledge of malaria, socio-economic status and parity and community participations were found to be the major factors in different settings. These factors contribute to the low efficacy (60%) of the available ITNs [18][19][20]. Bearing in mind, Northern Ethiopia, the Tigray region, out of the total malaria exposed households, only 74% of them received at least one ITN [21].…”