Abstract
BackgroundMalaria remains endemic in Nigeria despite programmes and policies put in place toward malaria elimination. Long-lasting insecticidal nets have been documented to offer protection from malaria by preventing mosquito bites. While many studies have examined the factors associated with the use of bed nets in Nigeria and across Africa, little information is available on the factors associated with consistency of use of bed nets.MethodsThe data for this study were derived from a household survey conducted in three states in Nigeria (Akwa Ibom, Kebbi and Nasarawa) between July and September 2015 by the Health Communication Capacity Collaborative, a 5-year cooperative agreement supported by the United States Agency for International Development and the US President’s Malaria initiative and led by the Johns Hopkins Center for Communication Programs. The analysis was limited to a total of 3884 men and women selected from 2863 households with at least one bed net. Multilevel multinomial logistic regression was used to assess the factors associated with consistency of use of bed nets.ResultsThe findings revealed 43.2% of the respondents use bed nets every night, while 38.4% use bed nets most nights. The factors associated with using a bed net every night rather than rarely or never using a bed net included sociodemographic and household variables (age, gender, religion, household size, net density, and household wealth), ideational variables (perceptions about severity, susceptibility, self-efficacy to use nets, and response-efficacy of bed net; awareness of place of purchase; willingness to pay for bed nets; attitudes towards net use; and descriptive norm about nets), and state of residence. The three study states differ significantly in terms of most of the independent variables included in the estimated model.ConclusionsThe study recommends that efforts designed to promote consistent use of bed nets should be state-specific and include strategies targeting ideational variables. Furthermore, given the significance of unmeasured heterogeneity at the cluster level, strategies to engage and mobilize the community, such as community dialogue, home visits and engaging community leadership, are relevant.
Highlights
Malaria remains endemic in Nigeria despite programmes and policies put in place toward malaria elimination
World Health Organization (WHO) recognizes this strategy as the primary prevention method and recommends mass distribution campaigns to scale up insecticide-treated net (ITN) in areas prone to malaria [1]
Setting The data for this study were drawn from household sample survey data collected in Nigeria between July and October 2015 by the Health Communication Capacity Collaborative (HC3), a 5-year cooperative agreement supported by United States Agency for International Development (USAID) and the US President’s Malaria initiative (PMI) and led by the Johns Hopkins Center for Communication Programs
Summary
Malaria remains endemic in Nigeria despite programmes and policies put in place toward malaria elimination. Long-lasting insecticidal nets have been documented to offer protection from malaria by preventing mosquito bites. Malaria is endemic to Nigeria and the majority of the population is at risk. Nigeria accounted for 52% of the 110 million malaria cases in the West Africa region in 2016 [1]. Insecticide-treated nets (ITNs; including long-lasting insecticidal nets—LLIN) represent the most cost-effective malaria prevention strategy. WHO recognizes this strategy as the primary prevention method and recommends mass distribution campaigns to scale up ITNs in areas prone to malaria [1]. Use of LLINs, remains the cornerstone of malaria prevention in Nigeria [5]
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