Decision-making on intra-household allocation of bed nets in Uganda: do households prioritize the most vulnerable members?

Lam, Yukyan; Harvey, Steven A.; Monroe, April; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel

doi:10.1186/1475-2875-13-183

Cited by 22 publications

(34 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar results were found in a study in Indonesia, Timor-Leste [41]. As our studies and that of Lam et al [42] in Uganda illustrate, most populations understand the vulnerability of pregnant women and children under 5 years of age, which has been conveyed by previous policies through the LLIN distribution strategy and other communications. This information has had an impact on the choice of LLIN bene ciaries in households [42].…”

Section: Decision-making Process For Llin Recipientssupporting

confidence: 91%

“…As our studies and that of Lam et al [42] in Uganda illustrate, most populations understand the vulnerability of pregnant women and children under 5 years of age, which has been conveyed by previous policies through the LLIN distribution strategy and other communications. This information has had an impact on the choice of LLIN bene ciaries in households [42]. Children under 5 years of age bene t from LLINs, sometimes considerably more than pregnant women, but to the detriment of those over 5 years of age, especially when LLINs are more accessible [22,[40][41][42][43].…”

Section: Decision-making Process For Llin Recipientsmentioning

confidence: 54%

“…This information has had an impact on the choice of LLIN bene ciaries in households [42]. Children under 5 years of age bene t from LLINs, sometimes considerably more than pregnant women, but to the detriment of those over 5 years of age, especially when LLINs are more accessible [22,[40][41][42][43].…”

Section: Decision-making Process For Llin Recipientsmentioning

confidence: 99%

See 2 more Smart Citations

Social vulnerability of children aged 5 to 15 years to malaria in Madagascar: 3 anthropological studies LLIN use

Njatosoa

Mattern

Pourette

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundAlthough it is accepted that long lasting insecticide bed net (LLIN) use is an effective means to prevent malaria, children aged 5 to 15 years do not appear to be sufficiently protected in Madagascar; malaria prevalence is highest in this age group. The purpose of this article is to summarize recent qualitative studies describing LLIN use among children aged 5–15 years and explore options to increase their use in this age group.MethodsQualitative data from three anthropological studies on malaria conducted between 2012 and 2016 in 10 districts of Madagascar were analyzed. These studies cover all malaria epidemiological profiles and 10 of the 18 existing ethnic groups in Madagascar. A thematic analysis was conducted on the collected data from semi-structured interviews, direct observation data, and informal interviews.ResultsA total of 192 semi-structured interviews were conducted. LLINs are generally perceived positively because they protect the health and well-being of users. However, regional representations of mosquito nets may contribute to LLIN nonuse by children over 5 years of age including the association between married status and LLIN use, which leads to the refusal of unmarried young men to sleep under LLINs; the custom of covering the dead with a mosquito net, which leads to fear of LLIN use; and taboos governing sleeping spaces for siblings of opposite sexes, which leads to LLIN shortages in households. Children under 5 years of age are known to be the most vulnerable age group for acquiring malaria and therefore are prioritized for LLIN use when there are limited supplies in households. In contrast, children over 5 years of age, who are perceived to be at less risk for malaria, often sleep without LLINs.ConclusionsPerceptions, social practices and regional beliefs regarding LLINs s and vulnerability to malaria contribute to the nonuse of LLINs among children over 5 years of age in Madagascar. Modifying LLIN policies to account for these factors may increase LLIN use in this age group and reduce disease burden.Trial registrationNot applicable

show abstract

Section: Decision-making Process For Llin Recipientssupporting

confidence: 91%

Section: Decision-making Process For Llin Recipientsmentioning

confidence: 54%

See 1 more Smart Citation

Social vulnerability of children aged 5 to 15 years to malaria in Madagascar: 3 anthropological studies LLIN use

Njatosoa

Mattern

Pourette

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Caregivers may prioritize younger children, who are more susceptible to the sequelae of malaria, as has been previously documented in the household allocation of malaria prevention tools in Uganda. 28 Interestingly, in the bivariate regression model, older children were more likely to receive prompt care, although this association vanished in the multivariate regression model.…”

Section: Resultsmentioning

confidence: 96%

Cost and Predictors of Care-Seeking Behaviors Among Caregivers of Febrile Children—Uganda, 2009

Menon

Njau

McFarland³

2016

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Fever is a major cause of morbidity and mortality among children under 5 years of age in resource-limited countries. Although prevention and treatment of febrile illnesses have improved, the costs-both financial and nonfinancialremain barriers to care. Using data from the 2009 Uganda Malaria Indicator Survey, we describe the costs associated with the care of a febrile child and assess predictors of care-seeking behavior. Over 80% of caregivers sought care for their febrile child, however less than half did so on either the day of or the day after the development of fever. The odds of seeking care decreased with each additional month of the child's age. Caregivers living in rural areas were more likely to seek care, however were less likely to seek care promptly. Caregivers with at least a primary school education and those familiar with the protective effect of bed nets and the need to seek care promptly were more likely to seek care. Despite government assistance, the majority of caregivers did incur costs (mean 13,173 Ugandan shilling; $6.84 U.S. dollars) associated with medical care. Continued efforts targeting barriers to seeking care, including the economic burden, are necessary.

show abstract

“…The net allocation exercise rankings, where respondents prioritized infants and pregnant women for best nets, falls in line with pre-universal coverage strategies of prioritizing vulnerable populations, and echoes priorities from studies in Uganda [20] and Tanzania [21] and analyses of recent DHS and the Malaria Indicator Survey (MIS) data [22]. While many families did express concern that there were not enough nets to cover all of their family members, they felt it was important to prioritize more vulnerable family members.…”

Section: Discussionmentioning

confidence: 99%

Net use, care and repair practices following a universal distribution campaign in Mali

Leonard

Diop²,

Doumbia³

et al. 2014

Malar J

Self Cite

View full text Add to dashboard Cite

BackgroundThe Government of Mali and the President’s Malaria Initiative conducted a long-lasting, insecticidal net (LLIN) distribution campaign in April 2011 in the Sikasso region of Mali, with the aim of universal coverage, defined as one insecticide-treated net for every two persons. This study examines how households in post- and pre-campaign regions value and care for nets.MethodsThe study was conducted in October 2012 in Sikasso and Kayes in the southeast and western regions of Mali, respectively. The regions were purposively selected to allow for comparison between areas that had already had a mass distribution campaign (Sikasso) and areas that had not yet had a mass distribution campaign (Kayes). Study sites and households were randomly selected. Sleeping space questionnaires and structured interviews with household heads were conducted to obtain information on net use, perceived value of free nets in relation to other malaria prevention activities, and net care and repair practices.ResultsThe study included 40 households, split evenly across the two regions. Forty interviews were conducted with household heads and 151 sleeping spaces were inventoried using the sleeping space questionnaire. Nets obtained through the free distribution were reported to be highly valued in comparison to other malaria prevention strategies. Overall, net ownership and use were higher among households in areas that had already experienced a mass distribution. While participants reported using and valuing these nets, care and repair practices varied.ConclusionNational net use is high in Mali, and comparatively higher in the region covered by the universal distribution campaign than in the region not yet covered. While the Government of Mali and implementing partners have made strides to ensure high net coverage, some gaps remain related to communication messaging of correct and consistent net use throughout the year, and on improving net care and repair behaviour. By focusing on these areas as well as improved access to nets, coverage and use rates should continue to increase, contributing to improvements in malaria control.

show abstract

Decision-making on intra-household allocation of bed nets in Uganda: do households prioritize the most vulnerable members?

Cited by 22 publications

References 22 publications

Social vulnerability of children aged 5 to 15 years to malaria in Madagascar: 3 anthropological studies LLIN use

Social vulnerability of children aged 5 to 15 years to malaria in Madagascar: 3 anthropological studies LLIN use

Cost and Predictors of Care-Seeking Behaviors Among Caregivers of Febrile Children—Uganda, 2009

Net use, care and repair practices following a universal distribution campaign in Mali

Contact Info

Product

Resources

About