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Access and Use of Long Lasting Insecticide-Treated Net Among Households in Enugu East Local Government Area of Enugu State, Nigeria

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Access and Use of Long-Lasting Insecticide-treated Net Among Households in Enugu East Local Government Area of Enugu State, Nigeria.

ABSTRACT

Recognizing the need for everyone to sleep under a long-lasting insecticide-treated net (LLINs), the Roll-Back-Malaria (RBM) and African Heads of states, in April 2000, established the “Abuja targets,” which includes LLIN use by at least 60% of pregnant women and under-fives in Africa by 2005.

These targets and those of the Millennium Development Goals to reduce malaria morbidity and mortality can only be achieved through a high access rate of LLINs and insurance that people who receive the nets actually sleep under them on a regular basis.

This study aimed to ascertain access and use of LLIN, as well as the effects of behavioral change on the use of LLIN among households in Enugu East Local Government Area (EELGA) of Enugu State, Nigeria.

The questionnaire was administered to 17 households selected from each of the 24 communities in EELGA by a combination of purposive and snowball techniques.

Results showed that access to LLIN was significant (76%), but the use of LLIN was not significant (21.1%). About 72.8% of respondents agreed that habit had a significant effect on the use of LLIN among households in Enugu East Local Government Area of Enugu State of Nigeria.

Apathy to government programs (77.7%), fear of side-effects (82.1%), distortion of sleeping arrangements inside the home (80.1%), interference of nets with daily activities in non-bed sites (79.1%), the apparent absence of mosquitoes (77.7%), and perceived net ineffectiveness (76.7%) were aspects of habit or behavioral change that affected the use of LLIN by households in EELGA of Enugu State, Nigeria.

It was recommended that behavior change should become the next issue to tackle in the efforts to roll malaria back in communities.

TABLE OF CONTENTS

Title page – – – – – – – – – – i
Certificate page – – – – – – – – – ii
Approval page – – – – – – – – – iii
Dedication – – – – – – – – – – iv
Acknowledgements – – – – – – – – – v
Table of contents – – – – – – – – – vi
Abstract – – – – – – – – – – ix

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study – – – – – – – 1
1.2 Statement of the problem – – – – – – – 8
1.3 Objectives of the study – – – – – – – 9
1.4 Research Questions – – – – – – – – 10
1.5 Research Hypotheses – – – – – – – – 10
1.6 Significance of the Study – – – – – – – 10
1.7 Scope and delimitations of the study – – – – – – 11

CHAPTER TWO: REVIEW OF RELEVANT LITERATURE

2.1 Introduction – – – – – – – – – 12
2.2 Conceptual Literature – – – – – – – – 12
2.3 Theoretical Literature – – – – – – – – 17
2.3.1 Theories of Behavioural Change Communication – – – – 24
2.3.1.1 The Cultivation or Enculturation Theory – – – – – 24
2.3 Empirical Studies – – – – -` – – – 25

CHAPTER THREE: METHODOLOGY

3.1 Introduction – – – – – – – – – 32
3.2 Research Design – – – – – – – – 32
3.3 Area of Study – – – – – – – – 33
3.4 Nature and Sources of Data – – – – – – – 36
3.5 Population of Study – – – – – – – – 36
3.6 Sample Size – – – – – – – – – 37
3.7 Sampling Technique – – – – – – – – 37
3.8 Instrument of Data Collection – – – – – – 38
3.9 Validation of the Instrument – – – – – – – 38
3.10 Reliability of the Instrument – – – – – – – 39
3.11 Method of Data Analysis – – – – – – – 39

CHAPTER FOUR: PRESENTATION AND ANALYSIS OF DATA

4.1 Introduction – – – – – – – – – 41
4.2 Distribution of Questionnaire – – – – – – 41
4.3 Biodata of Respondents – – – – – – – 42
4.4 Access to LLIN – – – – – – – – 45
4.5 Use of LLIN – – – – – – – – – 45
4.6 Behavioural change effect on use of LLIN – – – – – 46
4.7 Factors affecting the use of LLIN- – – – – – – 47
4.8 Test of Hypotheses – – – – – – – – 52

CHAPTER FIVE: DISCUSSION OF FINDINGS

5.1 Access to LLIN by Households in EELGA – – – – – 55
5.2 Use of LLIN by Households in EELGA – – – – – 55
5.3 Behavioural change effect on the use of LLIN by households in EELGA – 56

CHAPTER SIX: SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATION

6.1 Summary of findings – – – – – – – – 57
6.2 Conclusion – – – – – – – – – 58
6.3 Recommendation – – – – – – – – 58
References – – – – – – – – – 59

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Disease control and prevention are important components of health security. A growing body of evidence shows globally those ambitious health goals such as the health-related Millennium Development Goals (MDGs) cannot be achieved without greater attention to and more effective investment in health systems.

A handful of disease-specific interventions are being financed through various global health initiatives (GHIs). These unprecedented investments have undoubtedly yielded returns in terms of improved specific health outcomes for AIDS, tuberculosis (TB), and malaria (WHO, 2007).

However, malaria control will not eliminate the mosquito vector, the parasite, or the favorable environmental conditions for transmission in many locations.

To keep malaria at bay, countries must maintain high levels of coverage of preventative interventions even in the absence of a large number of cases.

Relaxation of control – whether because of the decline in political will, a decrease in funding, or some other reasons – increases the risk of resurgence in transmission and of epidemics.

The goal of sustained control is to maintain universal coverage with interventions until countries enter the elimination stage.

Sustained control will require strong political commitment at a country level and a continued focus on the health systems activities started during scale-up (particularly communication and behavior change efforts and monitoring and evaluation).

In addition, maintaining high coverage levels will require effective distribution approaches aimed at strengthening all routine delivery mechanisms and improving integration with other disease programs where appropriate.

REFERENCES

Alessandro U (2001). The Gambian national impregnated bednet programme: costs, consequences and net cost-effectiveness. Soc Sci Med. 46(2): 181-91.
Amofah G, Grabowsky M, Nobiya T, Ahun M, Donna R, Lengor M, Zimmerman D, Ladd H, Hoekstra E, Bello A, Baffoe-Wilmot A (2005). Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage. Bull World Health Organ. 83:195-201.
Brentlinger PE, Correia CMA, Chinhacata FS, Gimbel-Sherr KH, Stubbs B, Mercer MA (2007). Lessons learned from bednet distribution in Central Mozambique. Health Policy Plan. 22:103-110.
CWIQ Survey, 2006. Core welfare indicator questionnaire. Abuja: National Planning Commission.
Eboh, E.C. 2009. Social and Economic Research, Principles and Methods. Enugu: New Generation Books.

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