Household ownership and utilization of insecticide-treated nets under the Regional Artemisinin Resistance Initiative in Myanmar

Abstract

BackgroundMalaria is a major public health problem in Myanmar with reported artemisinin resistance. Myanmar promotes the use of insecticide-treated nets (ITNs) through the free delivery of long-lasting insecticide nets (LLINs) with target coverage of at least 80% in moderate and high-risk areas by 2014. Migrant people are at greater risk of malaria. They have significant barriers to health care services for febrile illness and malaria. Thus, a community-based survey was conducted among the migrant population to assess the ownership and utilization of bed nets (ITN/LLINs) for malaria.MethodsThe study analyzed secondary data from a community-based malaria survey conducted in 2014 among migrant population in 30 randomly selected townships out of 52 Regional Artemisinin Resistance Initiative (RAI) townships. In each township, five migrant sites were randomly selected (total of 150 migrant sites). A total of 3933 households (approximately 125 households from each township) were selected.ResultsOf 3923 households assessed, 97% had access to at least one bed net (any type), but only half had access to ITN/LLINs. Only 24% of households had adequate ITN/LLIN access (at least one ITN/LLIN per two persons). In terms of household utilization, 94.3% slept under a bed net (any type) the previous night. Only 43.4% slept under an ITN/LLIN. ITN/LLIN utilization in children under 5 years and pregnant women (high-malaria risk groups) was 45.3 and 46.6%, respectively. Of all nets, 31.3% had holes or had already undergone repairs. In terms of insecticide treatment status, 52.9% of bed nets were untreated and 35.9% of ITNs had not been treated with insecticide for more than a year.ConclusionThis study highlights poor access and high utilization of ITN/LLINs among migrant population, particularly among children and pregnant women. It highlights the need for improving bed net coverage and access to ITN/LLINs through bed net distributions and/or social marketing with the focus on migrant population and targeting of households with children and pregnant women.

Long Lasting Insecticide-treated Bed Net Ownership, Utilization and Associated Factors Among School-age Children in Dara Mallo and Uba Debretsehay Districts, Southern Ethiopia

“…Bed net utilization was signi cantly associated with the presence of either a pregnant mother or under ve years aged children in the household among internally displaced households in the Democratic Republic of Congo (16), household members in the Budondo sub-country in Uganda (28), a national community based survey in Madagascar (30). In agreement with our nding, bed net utilization by SAC was not affected by the presence of pregnant mother or children aged less than ve years in the household in Malawi (45) and general population in Yemen (38). In addition to the above explanation, these disparities between studies could be due to differences in the culture as pregnant women or young children might share the same sleeping place with the SAC.…”

“…According to this study, the bed net utilization was higher among children in rural area as compared to those in urban area. In Malawi, the bed net utilization was positively associated with being resident in urban areas but not with female gender (45) which was also similar with respect to gender in Yemen (38). In similar to our nding, gender related difference in the utilization of bed net was not seen in a community based cross-sectional study in Katakwi district in Uganda (32).…”

“…The ownership of bed net was lower than the coverage estimated in the most recent malaria indicator survey in Ethiopia (13) and most other studies conducted in Ethiopia (21, 24, 28, 29) except a study conducted among households of pregnant mothers in Shashogo district in Southern Ethiopia (22). The nding from the present study was also lower as compared to similar studies conducted outside Ethiopia such as national and district level studies in Uganda (30-32),Madagascar (33), Ghana (34,35), Zimbabwe (36), Equatoria Guinea (37), Yemen (38), among migrant population in Myanmar (39) and in Kenya (40). The higher ownership of bed nets in these countries and speci c study localities might be occurred due to difference in the study population since pregnant mothers and children age less than vers were known to be at higher risk of malaria or timing of data collection relative to the time when the distribution has occurred since some bed nets get lost because of different reasons as time goes on.…”

“…The bed net utilization by SAC in the study area was lower than its utilization by people living in malaria endemic areas in Africa (1). The bed net utilization was lower among this study population (20,21,24,28,29) as compared to pregnant mothers, children age less than ve years in Ethiopia as well as other countries outside Ethiopia like the general population and under ve children in Zimbabwe (36), SAC in Uganda, Tanzania and Yemen (31,38,(40)(41)(42), care givers of under ve children in Ghana (35), SAC and the general population in Kenya (40) and Nigeria (43). These differences could be due to differences on the level of awareness of the targeted population as pregnant women and children age less than ve years were well known high risk population groups than the SAC.…”

Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015–2016

“…Previous studies in African countries have reported higher utilization of ITNs among children ranging from 42 to 51% [7,23]. Studies from Myanmar have also reported higher ITN utilization of 45-50% among the migrant population and the Regional Artemisinin Resistance Initiative areas of Myanmar, probably due to the increased focus of the programme through heightened routine activities and increased external funding in these high risk areas [24,25]. Reasons for poor ITN utilization among caregivers of under-five children in this study need to be explored through qualitative research.…”