Abstract
BackgroundPoor people bear a disproportionate burden of malaria and prevention measures may not reach them well. A study carried out to examine the socio-economic factors associated with ownership and use of treated bed nets in Cross River and Bauchi States of Nigeria took place soon after campaigns to distribute treated bed nets.MethodsA cross-sectional household survey about childhood illnesses among mothers of children less than four years of age and focus group discussions in 90 communities in each of the two states asked about household ownership of treated bed nets and their use for children under four years old. Bivariate and multivariate analyses examined associations between socio-economic and other variables and these outcomes in each state.ResultsSome 72% of 7,685 households in Cross River and 87% of 5,535 households in Bauchi State had at least one treated bed net. In Cross River, urban households were more likely to possess bed nets, as were less-poor households (enough food in the last week), those with a male head, and those from communities with a formal health facility. In Bauchi, less-poor households and those with a more educated head were more likely to possess nets. In households with nets, only about half of children under four years old always slept under a net: 54% of 11,267 in Cross River and 57% of 11,277 in Bauchi. Factors associated with use of nets for young children in Cross River were less-poor households, fewer young children in the household, more education of the father, antenatal care of the mother, and younger age of the child, while in Bauchi the factors were a mother with more education and antenatal care, and younger age of the child. Some focus groups complained of distribution difficulties, and many described misconceptions about adverse effects of nets as an important reason for not using them.ConclusionDespite a recent campaign to distribute treated bed nets, disadvantaged households were less likely to possess them and to use them for young children. Efforts are needed to reach these households and to dispel fears about dangers of using treated nets.
Highlights
Poor people bear a disproportionate burden of malaria and prevention measures may not reach them well
Despite recent advances, malaria remains a major cause of morbidity and mortality, especially in sub-Saharan Africa, and 90% of global malaria deaths occur in subSaharan Africa [1]
Across the 90 communities, the number of households visited was higher in Cross River, but the number of children aged 0–47 months included in the sample was very similar between Cross River and Bauchi
Summary
Poor people bear a disproportionate burden of malaria and prevention measures may not reach them well. It is recognized that poor people bear a disproportionate burden of malaria deaths [2], yet malaria control measures do not reach poor people well [3]. There are more cases and deaths from malaria in Nigeria than in any other country; malaria is responsible for 60% of outpatient visits and 30% of hospitalizations in children under five years old in Nigeria and contributes to perhaps 11% of maternal mortality [4]. An indicator for measuring progress against the GMAP targets, as well as for progress against the Millenium Development Goal (MDG) 6, is the proportion of children aged under five years old who slept under a treated bed net the previous night [1]
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