Using the Ghana malaria indicator survey to understand the difference between female and male-headed households and their prevention and testing for malaria among children under 5

Abstract

Background Globally, 94% of malaria deaths occur in sub-Saharan Africa, and children under age 5 account for 70% of malaria-related mortality in the region. This study sought to examine differences between female-headed households (FHHs) and male-headed households (MHHs) with regard to malaria prevention and testing among children under age 5 (U5) in Ghana. Methods This cross-sectional study used publicly available data from the 2019 Ghana Malaria Indicator Survey (GMIS). Frequencies and descriptive statistics were calculated for all key variables. Bivariate analyses comparing FHHs and MHHs were conducted using t tests and Chi-square analysis. A P value of 0.05 was taken for statistical significance. Results Five thousand one hundred and eighty one household were identified, of which 1938 (37.4%) were female-headed and 3243 (62.6%) were male-headed. 51.7% of FHHs included a child U5, whereas 67.8% of MHHs included a child U5. MHHs were significantly more likely to own an ITN than FHHs (83.1% vs. 78.3%, P < 0.001), whereas FHHs were more likely to report taking malaria prevention steps such as spraying the house with insecticide, filling in stagnant puddles, and keeping surroundings clear (all significant at P < 0.001). U5 children in MHHs were more likely to sleep under a bed net the night preceding the survey (51.0%) than U5 children in FHHs (44.8%), although the finding was not statistically significant. The rates of fevers in the previous two weeks among children U5 were similar across MHH and FHH (24.2% vs. 22.3%), and the rates of testing for malaria among those who experienced a febrile episode were also similar across MHHs and FHHs (39.0% vs. 41.3%). Of those tested, the percentage of U5 children who tested positive for malaria was also similar across MHHs and FHHs (63.9% vs. 63.0%). Conclusions Both FHHs and MHHs in Ghana make a concerted effort to prevent and test for malaria among children U5 in their households. Despite differences in malaria prevention strategies, there were no significant difference in febrile episodes, malaria testing, and rates of positivity, suggesting that malaria prevention is challenging for all households in Ghana. In the face of a newly-developed malaria vaccine, future research is warranted to ensure adequate uptake across all households.

Exploring the role of spending on malaria incidence in Uganda using the auto-regressive distributed lag approach

“…This is meant to illustrate how gender roles affect how households control malaria. Recently, it has been argued that female-headed families are more likely to report adopting preventative measures against malaria, such as dousing the home in pesticide, draining stagnant puddles, and maintaining a clear environment [ 26 ]. However, this may not always be true.…”

Prevalence and determinants of malaria infection among pregnant women attending antenatal clinic in Ejisu government hospital in Ghana: A cross-sectional study

“…Barry et al [ 44 ] found a link between head of household and malaria preventive measures among pregnant women in Guinea. A Ghanaian study found that homes that were headed by males were more likely to own ITN [ 45 ]. As a result, health workers should strengthen partner involvement in ANC activities as this can help drive home preventive education on malaria, such as ITN use.…”

Identifying childhood malaria hotspots and risk factors in a Nigerian city using geostatistical modelling approach

“…In 2018, Sub-Saharan Africa (SSA) accounted for 94% of global malaria deaths. Furthermore, children under the age of five (U5) accounted for 70% of malaria-related mortality in the SSA region 2 , 3 . An increase to 96% of malaria-related death is recorded in WHO African Region in 2021, and the top 16 malaria-affected countries are all situated in SSA.…”