Coverage and use of insecticide-treated bed nets in households with children aged under five years in Liberia

Bawo, Luke; Harries, Anthony; Reid, Tony; Massaquoi, Moses; Jallah-Macauley, Rose; Jones, Jennifer English; Wesseh, Chea Sanford; Enders, Jeanne; Hinneh, L.

doi:10.5588/pha.12.0040

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…Furthermore, married respondents were 23% more likely to own a net when compared with single respondents. This is consistent with Kimbi et al ( 37 ) who linked the finding to the fact that married women received financial aid from their husbands unlike single women who struggle on their own to take care of all family responsibilities ( 37 ). Findings from elsewhere reasoned that a household with both parents living together is more likely to make a better decision in favor of the use of LLINs to prevent malaria infection than others ( 33 , 38 ).…”

Section: Discussionsupporting

confidence: 91%

Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study

Afagbedzi,

Alhassan,

Kenu

et al. 2023

Front. Public Health

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BackgroundMalaria continues to be one of the leading causes of mortality and morbidity, especially among children and pregnant women. The use of Long-Lasting Insecticide Nets (LLINs) has been recognized and prioritized as a major intervention for malaria prevention in Ghana. This study aims to establish the factors influencing the universal coverage and utilization of LLINs in Ghana.MethodsThe data used for this study was from a cross-sectional survey carried out to assess LLINs ownership and use in 9 out of the 10 old regions of Ghana from October 2018 to February 2019 where free LLIN distribution interventions were implemented. The EPI “30 × 7” cluster sampling method (three-stage sampling design) was modified to “15 × 14” and used for the study. A total of 9,977 households were interviewed from 42 districts. Descriptive statistics using percentages as well as tests of associations such as Pearson Chi-square and the magnitude of the associations using simple and multivariable logistic regression were implemented.ResultsOf the 9,977 households in the study, 88.0% of them owned at least one LLIN, universal coverage was 75.6%, while utilization was 65.6% among households with at least one LLIN. In the rural and urban areas, 90.8% and 83.2% of households, respectively, owned at least one LLIN. The was a 44% increase in universal coverage of LLINs in rural areas compared to urban areas (AOR: 1.44, 95% CI: 1.02–2.02). There were 29 higher odds of households being universally covered if they received LLIN from the PMD (AOR: 29.43, 95% CI: 24.21–35.79). Households with under-five children were 40% more likely to utilize LLIN (AOR: 1.40, 95% CI: 1.26–1.56). Respondents with universal coverage of LLIN had 25% increased odds of using nets (AOR: 1.25 95% CI: 1.06–1.48). Rural dwelling influences LLIN utilization, thus there was about 4-fold increase in household utilization of LLINs in rural areas compared to urban areas (AOR: 3.78, 95% CI: 2.73–5.24). Household size of more than 2 has high odds of LLINs utilization and awareness of the benefit of LLINs (AOR: 1.42, 95% CI: 1.18–1.71).ConclusionAbout nine in 10 households in Ghana have access at least to one LLIN, three-quarters had universal coverage, and over two-thirds of households with access used LLIN. The predictors of universal coverage included region of residence, rural dwellers, and PMD campaign, while households with child under-five, in rural areas, and with universal coverage were positively associated with utilization.

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Section: Discussionsupporting

confidence: 91%

Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study

Afagbedzi,

Alhassan,

Kenu

et al. 2023

Front. Public Health

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“…Household headed by married and widowed persons were more likely to own bednets than households headed by singles. This has been attributed to the much better decision making power in parented households and also their responsibility in protecting their offspring against disease [ 26 ]. Households with 5–12 individuals were more likely to own bednets than households with 1–4 individuals.…”

Section: Discussionmentioning

confidence: 99%

Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon

et al. 2017

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BackgroundMalaria is a serious health concern in Africa. In Cameroon, an endemic country where malaria remains a major public health problem, several control measures have been put in place among which the use of insecticide-treated bednets (LLINs/ITNs) is considered one of the core vector control strategies. However, the greatest challenges include ownership and utilisation by individuals and households. Factors such as age, marital status, gender, education and occupation of the household head, household size, knowledge of bednets, socioeconomic status, and environmental factors have been suggested to have an impact on bednet ownership and utilisation in different settings. The present study sought to determine bednet ownership and utilisation rates and to assess the impact of predictive factors on bednet ownership and use in the Bamenda Health District (BHD) of Cameroon.MethodsA cross-sectional study involving 384 households was conducted in six health areas in the BHD. A structured and semi-structured questionnaire was used to collect data on demographic and household characteristics as well as information on their bednet ownership and utilisation. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed.ResultsFrequency of bednet ownership was relatively high (63.5%) with LLINs being most abundant (91.9%); the majority of households (87.7%) obtained their bednets during the 2011 free distribution campaign. Utilisation was relatively high (69.3%), with negligence (29.3%) and heat discomfort (26.7%) accounting most for non-usage of bednets. Children less than 5 years (63%) and pregnant women (60%) most often used these nets. Households headed by a married couple, those with older household heads, household with smaller size (5–12 persons), and knowledge of bednets (good knowledge) had positive impacts on bednet ownership (p < 0.05). The gender of the household head (males), their educational level, environmental conditions (presence of suitable mosquito breeding sites), bednet number in households (greater number of bednets) and the prioritised groups (children < 5 and pregnant women) had positive impacts on bednet utilisation in households (p < 0.05). There was a negative association between bednet ownership and utilisation by households as bednet ownership was high and utilisation of these nets was low. Marital status and age of household head, household size, and knowledge of bednets had impacts on bednet ownership while gender and educational level of the household head, environmental suitability, the number of bednets and the two prioritised groups had an impact on bednet usage.ConclusionThese factors may be relevant for policy makers and in decision making for the intensification of campaign strategies to ensure more effective subsequent distribution campaigns in the BHD and beyond.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4155-5) contains supplementary material, which is available to authorized users.

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“…As previously reported in southwest Ethiopia [ 26 ], the marital status of household heads was associated with the access to LLIN in our study, with households headed by single or divorced heads four times more likely to lack sufficient access to LLINs than households headed by married couples. A decreased decision-making power in households with a single-parent family structure may explain their lower LLIN access in comparison with household with two-parent families, which may lead to a lower retention of nets (after being delivered) and/or acquisition of nets (in the market) to protect family members against malaria [ 40 ]. Moreover, the relationship between the education level of household heads and LLIN ownership has also been studied across several countries of sub-Saharan Africa, with no conclusive results.…”

Section: Discussionmentioning

confidence: 99%

Long-Lasting Insecticide Net Ownership, Access and Use in Southwest Ethiopia: A Community-Based Cross-Sectional Study

Seyoum

Speybroeck

Duchateau

et al. 2017

IJERPH

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Introduction: A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, access and use of LLNs in the malaria endemic southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in southwest Ethiopia during October–November 2015, including 836 households from sixteen villages around Gilgel-Gibe dam area. Indicators of ownership, access and use of LLINs were derived following the Roll Back Malaria (RBM) guidelines. Factors associated with failure for both LLIN access and use were analysed at household level using a multivariate logistic regression model. Results: The proportion of households with at least one LLIN was 82.7% (95% CI: 80.0, 85.1). However, only 68.9% (95% CI: 65.6, 71.9) had enough LLINs to cover all family members (with ≥one LLIN for every two persons). While 75.3% (95% CI: 68.4, 83.0) of the population was estimated to have accessed to LLINs, only 63.8% (95% CI: 62.3, 65.2) reported to have used a LLIN the previous night. The intra-household gap (i.e., households owning at least one LLIN, but unable to cover all family members) and the behavioral gap (i.e., household members who did not sleep under a LLIN despite having access to one) were 16.8% and 10.5%, respectively. Age, marital status and education of household heads, as well as household size and cooking using firewood were associated with the access to enough LLINs within households. Decreased access to LLINs at households was the main determinant for not achieving ≥80% household members sleeping under a LLIN the previous night. Other associated factors were household size and education level of household head. Conclusions: LLIN coverage levels in study villages remain below national targets of 100% for ownership and 80% for use. The access to enough LLINs within the households is the main restriction of LLIN use in the study area.

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Coverage and use of insecticide-treated bed nets in households with children aged under five years in Liberia

Cited by 6 publications

References 7 publications

Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study

Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study

Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon

Long-Lasting Insecticide Net Ownership, Access and Use in Southwest Ethiopia: A Community-Based Cross-Sectional Study

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