Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study
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Date
2023
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Publisher
Frontiers Media S.A.
Abstract
Background: Malaria continues to be one of the leading causes of mortality and
morbidity, especially among children and pregnant women. The use of LongLasting Insecticide Nets (LLINs) has been recognized and prioritized as a major
intervention for malaria prevention in Ghana. This study aims to establish the
factors influencing the universal coverage and utilization of LLINs in Ghana.
Methods: The data used for this study was from a cross-sectional survey carried
out to assess LLINs ownership and use in 9 out of the 10 old regions of Ghana
from October 2018 to February 2019 where free LLIN distribution interventions
were implemented. The EPI “30 × 7” cluster sampling method (three-stage
sampling design) was modified to “15 × 14” and used for the study. A total of
9,977 households were interviewed from 42 districts. Descriptive statistics using
percentages as well as tests of associations such as Pearson Chi-square and the
magnitude of the associations using simple and multivariable logistic regression
were implemented.
Results: Of the 9,977 households in the study, 88.0% of them owned at least
one LLIN, universal coverage was 75.6%, while utilization was 65.6% among
households with at least one LLIN. In the rural and urban areas, 90.8% and 83.2%
of households, respectively, owned at least one LLIN. The was a 44% increase in
universal coverage of LLINs in rural areas compared to urban areas (AOR: 1.44,
95% CI: 1.02–2.02). There were 29 higher odds of households being universally
covered if they received LLIN from the PMD (AOR: 29.43, 95% CI: 24.21–35.79).
Households with under-five children were 40% more likely to utilize LLIN (AOR:
1.40, 95% CI: 1.26–1.56). Respondents with universal coverage of LLIN had 25%
increased odds of using nets (AOR: 1.25 95% CI: 1.06–1.48). Rural dwelling
influences LLIN utilization, thus there was about 4-fold increase in household
utilization of LLINs in rural areas compared to urban areas (AOR: 3.78, 95% CI:
2.73–5.24). Household size of more than 2 has high odds of LLINs utilization and
awareness of the benefit of LLINs (AOR: 1.42, 95% CI: 1.18–1.71).
Conclusion: About nine in 10 households in Ghana have access at least to one LLIN,
three-quarters had universal coverage, and over two-thirds of households with
access used LLIN. The predictors of universal coverage included region of residence,
rural dwellers, and PMD campaign, while households with child under-five, in rural
areas, and with universal coverage were positively associated with utilization.
Description
Research Article
Keywords
Universal coverage, Utilization of insecticidal nets, Long-lasting insecticide nets, Mosquito nets, Point mass distribution, Malaria prevention