Prevalence and factors associated with utilisation of insecticide treated bednets among pregnant women in Gulu District Internally Displaced Persons’ camps

Abstract

Background. Nearly 500 million people suffer a malaria episode every year and about 90% of all malaria deaths in the world today occur in sub-Sahara Africa. In Uganda, malaria accounts for about 30 - 50% of the outpatient burden and 35% of hospital admissions. The aim of the Roll Back Malaria global partnership is to halve malaria’s burden between 2000 and 2010 by scaling-up insecticide-treated nets (ITNs). ITN is one of the mainstay strategies for malaria control in Uganda. Objective. To establish the prevalence and factors associated with the utilisation of ITNs among pregnant women in Gulu district Internally Displaced Person (IDP) camps. Methods. Cross-sectional study was conducted using quantitative and qualitative data collection techniques in Gulu district IDP camps in March 2009. A total of 769 pregnant women from 20 randomly selected IDP camps (clusters) were interviewed. All households that had pregnant women in a cluster were consecutively sampled and four FGDs were conducted. Quantitative data was entered in EpiData version 3.1 and analyzed using STATA version 9. Qualitative data were analysed manually using thematic analysis technique. Results: Insecticide treated net utilisation was 35% (95% CI = 95% CI 0.46 - 0.62) and the factors which promote ITN utilisation among pregnant women were: Having attended ante-natal services (aOR = 2.11, 95% CI = 1.44 – 3.10, P-value = 0.000), Having heard about ITN (aOR = 1.71, 95% CI = 1.25 – 2.36, P-value = 0.001) and indoor residual spraying of houses (aOR = 2.52, 95% CI = 1.53 – 4.15, P-value = 0.000). Factors which hinder ITN utilisation among pregnant women were: Duration to reach health centre (aOR = 0.63, 95% CI = 0.40 – 1.00, P-value = 0.049), Being Single/Widowed/Divorced (aOR = 0.17, 95% CI 0.07 – 0.45, P-value 0.000) and Knowing groups most affected by malaria (aOR = 0.57, 95% CI = 0.39 – 0.85, P-value 0.005). Conclusion: The prevalence of ITN utilisation was greater than the national average of 10% but remained generally low at only 35% . Only a third of pregnant women in Gulu district IDP camps had utilized ITN which is below the target set by MoH of 50% of ITN coverage among vulnerable people by the year 2007. Stakeholders (Ministry of Health and NGOs) should ensure adequate supply of ITN in the health facilities in the IDPs. Camp leaders should encourage pregnant woman to acquire and use insecticide treated net.