Predictors of mosquito net use in Ghana

Abstract

BackgroundDuring the past decade the malaria control community has been successful in dramatically increasing the number of households that own mosquito nets. However, as many as half of nets already in households go unused. This study examines the factors associated with use of nets owned in Ghana.MethodsThe data come from an August 2008 survey in Ghana of households with a pregnant woman or a guardian of a child under five, conducted during the rainy season. 1796 households were included in this analysis, which generated a sample of 1,852 mosquito nets. Using each net owned as the unit of analysis, multivariate logistic regression was used to examine the relationship of net used last night with 23 potentially explanatory variables having to do with characteristics of the household, of the respondent, and of the net. Odds Ratios, p-values, and confidence intervals were calculated for each variable to develop an explanatory model.ResultsThe final multivariate model consisted of 10 variables statistically associated with whether or not the net was used the prior night: rural location, lower SES, not using coils for mosquito control, fewer nets in the household, newer nets and those in better condition, light blue colour, higher level of education of the guardian of the child under five, knowing that mosquitoes transmit malaria, and paying for the net instead of obtaining it free of charge.ConclusionsThe results of this study suggest that net use would increase in Ghana if coloured nets were made available in mass distributions as well as in the commercial market; if programmes emphasize that malaria is caused only by night-biting mosquitoes, and that nets protect against mosquitoes better than coils and need to be used even if coils are burning; if donated nets are replaced more frequently so that households have nets that are in good condition; and if there were support for the commercial market so that those who can afford to purchase a net and want to choose their own nets can do so.

Low Utilization of Insecticide-Treated Bed Net among Pregnant Women in the Middle Belt of Ghana

“…Some studies have shown that a personal decision to purchase a net may motivate one to use the ITNs [16] rather than getting it for free. Therefore it is important to encourage commercial distribution of ITNs but at a subsidized price that is at the barest minimum [23].…”

“…However, access does not always result in usage due to sociocultural and logistical reasons [15]. Evidence from some parts of Ghana has shown that over 40% of ITNs available in the households go unused [16]. This could erode the gains made in ITN use over the years.…”

Social economic factors and malaria transmission in Lower Moshi, Northern Tanzania

“…Education and occupation had an influence in vector control tools, therefore, knowledge and utility might have more impact on bed net effect for wide community protection either provided for free or under subsidized price [35,69,70]. In malaria-endemic parts of western Kenya and Ghana, studies have found that, the nets offered to pregnant mothers and infants during clinics visits do not mean utility for personal protection as many people own bed nets but do not use them [35,71]. …”

Do ownership of mosquito nets, dwelling characteristics and mothers’ socio-economic status influence malaria morbidity among children under the age of 5 in Cameroon?

“…This is critical for malaria transmission, given that radio programmes have assisted policy makers to identify critical channels for net utilization and compliance with safe practices in order to avoid being bitten by mosquitoes. In Cameroon, the impact of "KO Palu" which means "Knock Out Malaria" campaign was investigated and found to positively influence compliance with mosquito net usage and reduction of malaria episodes [9,41,42].…”