Ownership and utilization of insecticide treated nets (ITNS) among pregnant women and children under five years in the prevention of malaria in the Nanumba South District of the Northern Region of Ghana

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July, 2015
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Introduction: Ghana’s policy to reduce the burden of malaria in pregnancy and in children under five years advocates that, this vulnerable group always sleep under ITNs. A total of 411 pregnant women and caregivers were selected from the three sub districts for the study. 100 communities were randomly selected in a cross sectional study in August, 2013 to determine the household factors that influence the ownership and utilization of ITNs in the Nanumba South District. Methodology: 100 communities were randomly selected from the three sub districts. Approximately four household were selected from each community using systematic random sampling. One eligible respondent was selected in each household, but in household where there were more than one eligible respondent, simple random sampling was used to select one of them through the ballot method, because two people from the same household may share similar house hold characteristics. 175 pregnant women and 236 caregivers with children under five year formed the sample size Results and Discussion: The results from the study indicated that, ITNs ownership was 65.7% among pregnant women and 73.3% among caregivers and a general ownership of 70.3% With 70.3% of ITNs ownership among the respondents only 34.4% consistently used their ITNs. The study further showed that, 62(21.4%) of the respondents had at least one net and majority of them 227(78.6%) had more than one net. Long lasting insecticide nets (LLINs) were the majority of the nets owned by the respondents 268(92.7%), with treated nets recording 13(4.5%) and other types of nets with 8(2.8%). The level of education of the respondents influenced ITNs use with P-value of 0.01 this implies that there is a strong association between ITNs use and level of education. The findings also revealed that, the occupation has a positive association with ITNs usage with a p-value of 0.02. The respondents marital and religious status had weak association with ITNs use, marital status had a p-values of 0.31 and religious status with a p-value of 0.27. These finding implied that the marital and the religious status of the respondents did not influence ITNs use positively. From the study it can be seen that ITNs usage is greatly influence by the household structure. Majority of the respondents indicated that, the decision to sleep under ITNs was mostly made by men or husbands. Conclusion, the intra-household dynamics in ITNs use in households with pregnant women children under five years is complex and influenced by various social, economic and cultural realities. The success of ITN utilization largely depends on how households are able to cope with these challenges and how policy makers and implementing organs understand these challenges. Otherwise, continuous distribution of ITNs without proper knowledge on the intra-household dynamics will continue to offer little success in prevention of malaria among the vulnerable group. This is evident in the high ITNs ownership and less usage by the household.
A thesis submitted to Department of Population, Family and Reproductive Health, College of Health Sciences, School of Public Health, in partial fulfillment of the requirement for the degree of Master of Public Health in Population and Reproductive Health, 2015