The use of insecticide-treated nets as part of the National Malaria Eradication Programme in Northwestern Province

Abstract

In Zambia, malaria remains a major public health threat. Understanding what influences the use of mosquito nets is important to speed up malaria prevention efforts in the country. The use of Insecticide-Treated Nets (ITNs) has been proven to be effective in the prevention of malaria. ITN use is the intended health behaviour to have the greatest impact on the malaria burden, however, it is important to establish what factors affect the use of mosquito nets. To assess the use of Insecticide-Treated Nets (ITNs) as part of the National Malaria Eradication Program (NMEP) in selected parts of the North-Western province. This study, which was retrospective and non-experimental in nature was set in the NorthWestern province of Zambia, focusing on men and women aged 15-49 years. It used secondary data from the 2018 Zambia Demographic and Health Survey (ZDHS), for 960 respondents (i.e., 296 women and 664 men). Survey participants were identified through a multi-stage stratified cluster sampling design during the 2018 ZDHS survey. Further, data analysis was done at three levels, namely univariate, bivariate and multivariate analysis levels. At multivariate level, binary logistic regression was used to investigate the magnitude of the influence the various factors in the outcome variable. Results showed that there was no association between education level (p-value = 0.212), age of the household head (p-value = 0.547), sex of the household head (p-value = 0.206), marital status (p-value = 0.162) and residence (p-value = 0.889) and use of a mosquito net. However, a positive significant association was observed between wealth index (p-value = 0.007), spraying of a dwelling against mosquitoes in the last 12 months before the survey (p-value = 0.000), the number of mosquito nets owned (p-value = 0.000) and the number of children under a mosquito net previous night (pvalue = 0.000) with use of a mosquito net. The study concludes that a lot still needs to be done if the fight against malaria is to be won. Ownership of a mosquito net does not necessarily translate into the use as not everyone who owned mosquito nets used them. This suggests that mosquito net distribution is not sufficient and should be accompanied by vigorous sensitization and health education on the importance of mosquito net use.