Factors associated with ownership and utilization of insecticide treated nets among children under five years in sub-Saharan Africa

Abstract

Background Insecticide-treated net (ITN) is a cost-effective means to control malaria and morbidity in under-five children. This study synthesizes the factors associated with using the ITN as a malaria prevention tool in sub-Saharan Africa. Methods There was an advanced search of four electronic databases, including PubMed Central, CINAHL, EMBASE, and Google Scholar, and identified articles between 2016 to April 2021. Following the title, abstract and full-text reading, 13 articles were deemed appropriate for this review. All the researchers developed, discussed, and accepted a matrix to extract relevant information from the studies. A convergent synthesis was adopted and allowed for integrating qualitative, quantitative, and mixed-method studies and transforming them into qualitative findings. Results Household and caregiver related factors that influenced utilization of the ITN were, Household heads having two or more sleeping places, a knowledge that ITN prevents malaria, the presence of hanging ITNs, high literacy, living female-headed households, birth spacing, unmarried mothers, and antenatal clinic attendance promoted utilization. Perceived malaria risk was a critical determinant of ITN ownership and utilization. Some factors that hindered the use of the ITN included hotness of the weather, absence of visible mosquitoes, cost, inadequate number, rooms designs, unaffordability, insufficient knowledge on causes of malaria, and poor attitude to use. Specific ITN factors that hindered use were color, chemicals use, odor, and shape. Conclusion It is important to use integrated multi-sectoral and culturally appropriate interventions to encourage households to prioritize and utilize the ITN in under-5 children.

Exploring a moderation analysis in the interactive relationship between determinants of ITN use in Ghana. A multi-level analysis based on the DHS 2019 malaria indicator survey

“…The low availability and ownership of ITNs signi cantly in uence ITN use since strategies for ITN access and ownership are mainly geared towards mass distributions of ITNs rather than towards targeted distributions based on intrahousehold (rooms available for sleeping, household size and composition, household relationship structure including other factors). Indeed, the targeted distribution of ITNs has been shown to effectively increase ITN use, especially among children under ve years of age [23,33,34].…”

“…This might lead to errors in the measurement of ITN use caused by social desirability bias, where households will probably overreport the number of household members sleeping under ITNs in the survey. Finally, the analysis of ITN use and its determinants based on the theoretical model is not widely extensive, as it excludes interactions at broader levels (employment, education, social and community networks, and the general socioeconomic, cultural, and environmental conditions), which have been explored in other studies [12,13,16,22,23].…”

Exploring a moderation analysis in the interaction between determinants of ITN use in Ghana. A multi-level analysis based on the DHS 2020 /2019 malaria indicator survey

“…Low availability and ownership of ITNs signi cantly in uence ITN use since strategies for ITN access and ownership are mainly geared towards mass distributions of ITNs rather than on targeted distribution based on intra-household factors (rooms available for sleeping, household size and composition, household relationship structure including other factors). Indeed, targeted distribution of ITNs has been shown to effectively increase ITN use especially among children under ve years [23,33,34].…”

“…It intends to provide an indepth understanding of context-speci c factors associated with ITN use to address the gap in ITN ownership and use at the household level. Much as several studies have analyzed the gap between ITN access, ITN ownership, and ITN use [16,20,22,23]; these studies have often examined a general relationship among factors at various levels and not speci cally the interaction among speci c factors such as children under ve years on household´s ownership and household members ITN use.…”

Mosquito bed net use and associated factors among pregnant women in Rwanda: a nationwide survey

“…Moreover, a previous study indicated ITN use in rural areas of Rwanda to be 57% [18], a utilization rate that is extremely lower compared to the targeted 85% set by the Rwanda National malaria control program and previously recorded rates [15,18]. Other factors previously associated with the utilization of bed nets include number of household members, with lower use among households with ve or more members; number of bed nets present in households, with high numbers positively correlating with greater usage; employment status, maternal educational attainment and ANC attendance and awareness of the importance bed net use [17,19,20].…”