Factors associated with insecticide-treated net usage among women of childbearing age in Malawi: A multilevel analysis

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Abstract

Background: This study aimed to identify factors at individual and community level influencing insecticide-treated net (ITN) usage among groups of women of childbearing age (WOCBA) in Malawi. Methods: Factors influencing ITN usage in Malawi were assessed through interviews with 16,130 WOCBA (15-49 years) across 850 communities who participated in the 2015-2016 Malawi Demographic Health Survey. Multilevel logistic regression analysis was used. Results: ITN use was similar between pregnant women and non-pregnant women with children under 5 years (45.9% and 46.9%, respectively), but slightly lower among non-pregnant women without children under 5 years (39.1%). Both individual and community characteristics were associated with ITN use among WOCBA and varied significantly across subgroups. Specifically, non-pregnant women with children under 5 years living in communities where women had high autonomy in health care decisions had an 18% greater odds of using an ITN compared with those from communities where women had low health care autonomy (adjusted odds ratio [aOR] = 1.18; 95% confidence interval [CI] 1.00-1.38). Distance to health care facility influenced ITN usage among pregnant women; those who did not regard distance as a problem had a 44% greater odds of using an ITN than those for whom distance was seen as a problem (aOR = 1.44; 95% CI 1.09-1.89). Number of household members, region, urbanization, and community ITN coverage influenced ITN usage across all WOCBA groups. Conclusion: The findings confirmed the importance of assessing various factors affecting ITN usage among groups of WOCBA. Both individual- and community-level factors should be considered when designing and implementing ITN programmes in Malawi.

Original languageEnglish
Article number372
JournalMalaria Journal
Volume17
Issue number1
DOIs
Publication statusPublished - Oct 19 2018

Fingerprint

Multilevel Analysis
Malawi
Insecticides
Delivery of Health Care
Pregnant Women
Odds Ratio
Confidence Intervals
Urbanization
Health Facilities
Age Groups
Logistic Models
Regression Analysis
Demography

Keywords

  • Insecticide-treated nets
  • Malaria
  • Malawi
  • Multilevel
  • Women of childbearing age

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

@article{2029264259594a3ca267b9d51b4035c0,
title = "Factors associated with insecticide-treated net usage among women of childbearing age in Malawi: A multilevel analysis",
abstract = "Background: This study aimed to identify factors at individual and community level influencing insecticide-treated net (ITN) usage among groups of women of childbearing age (WOCBA) in Malawi. Methods: Factors influencing ITN usage in Malawi were assessed through interviews with 16,130 WOCBA (15-49 years) across 850 communities who participated in the 2015-2016 Malawi Demographic Health Survey. Multilevel logistic regression analysis was used. Results: ITN use was similar between pregnant women and non-pregnant women with children under 5 years (45.9{\%} and 46.9{\%}, respectively), but slightly lower among non-pregnant women without children under 5 years (39.1{\%}). Both individual and community characteristics were associated with ITN use among WOCBA and varied significantly across subgroups. Specifically, non-pregnant women with children under 5 years living in communities where women had high autonomy in health care decisions had an 18{\%} greater odds of using an ITN compared with those from communities where women had low health care autonomy (adjusted odds ratio [aOR] = 1.18; 95{\%} confidence interval [CI] 1.00-1.38). Distance to health care facility influenced ITN usage among pregnant women; those who did not regard distance as a problem had a 44{\%} greater odds of using an ITN than those for whom distance was seen as a problem (aOR = 1.44; 95{\%} CI 1.09-1.89). Number of household members, region, urbanization, and community ITN coverage influenced ITN usage across all WOCBA groups. Conclusion: The findings confirmed the importance of assessing various factors affecting ITN usage among groups of WOCBA. Both individual- and community-level factors should be considered when designing and implementing ITN programmes in Malawi.",
keywords = "Insecticide-treated nets, Malaria, Malawi, Multilevel, Women of childbearing age, Insecticide-treated nets, Malaria, Malawi, Multilevel, Women of childbearing age",
author = "Owen Nkoka and Chuang, {Ting Wu} and Chuang, {Kun Yang} and Chen, {Yi Hua}",
year = "2018",
month = "10",
day = "19",
doi = "10.1186/s12936-018-2522-z",
language = "English",
volume = "17",
journal = "Malaria Journal",
issn = "1475-2875",
publisher = "BioMed Central",
number = "1",

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TY - JOUR

T1 - Factors associated with insecticide-treated net usage among women of childbearing age in Malawi

T2 - A multilevel analysis

AU - Nkoka, Owen

AU - Chuang, Ting Wu

AU - Chuang, Kun Yang

AU - Chen, Yi Hua

PY - 2018/10/19

Y1 - 2018/10/19

N2 - Background: This study aimed to identify factors at individual and community level influencing insecticide-treated net (ITN) usage among groups of women of childbearing age (WOCBA) in Malawi. Methods: Factors influencing ITN usage in Malawi were assessed through interviews with 16,130 WOCBA (15-49 years) across 850 communities who participated in the 2015-2016 Malawi Demographic Health Survey. Multilevel logistic regression analysis was used. Results: ITN use was similar between pregnant women and non-pregnant women with children under 5 years (45.9% and 46.9%, respectively), but slightly lower among non-pregnant women without children under 5 years (39.1%). Both individual and community characteristics were associated with ITN use among WOCBA and varied significantly across subgroups. Specifically, non-pregnant women with children under 5 years living in communities where women had high autonomy in health care decisions had an 18% greater odds of using an ITN compared with those from communities where women had low health care autonomy (adjusted odds ratio [aOR] = 1.18; 95% confidence interval [CI] 1.00-1.38). Distance to health care facility influenced ITN usage among pregnant women; those who did not regard distance as a problem had a 44% greater odds of using an ITN than those for whom distance was seen as a problem (aOR = 1.44; 95% CI 1.09-1.89). Number of household members, region, urbanization, and community ITN coverage influenced ITN usage across all WOCBA groups. Conclusion: The findings confirmed the importance of assessing various factors affecting ITN usage among groups of WOCBA. Both individual- and community-level factors should be considered when designing and implementing ITN programmes in Malawi.

AB - Background: This study aimed to identify factors at individual and community level influencing insecticide-treated net (ITN) usage among groups of women of childbearing age (WOCBA) in Malawi. Methods: Factors influencing ITN usage in Malawi were assessed through interviews with 16,130 WOCBA (15-49 years) across 850 communities who participated in the 2015-2016 Malawi Demographic Health Survey. Multilevel logistic regression analysis was used. Results: ITN use was similar between pregnant women and non-pregnant women with children under 5 years (45.9% and 46.9%, respectively), but slightly lower among non-pregnant women without children under 5 years (39.1%). Both individual and community characteristics were associated with ITN use among WOCBA and varied significantly across subgroups. Specifically, non-pregnant women with children under 5 years living in communities where women had high autonomy in health care decisions had an 18% greater odds of using an ITN compared with those from communities where women had low health care autonomy (adjusted odds ratio [aOR] = 1.18; 95% confidence interval [CI] 1.00-1.38). Distance to health care facility influenced ITN usage among pregnant women; those who did not regard distance as a problem had a 44% greater odds of using an ITN than those for whom distance was seen as a problem (aOR = 1.44; 95% CI 1.09-1.89). Number of household members, region, urbanization, and community ITN coverage influenced ITN usage across all WOCBA groups. Conclusion: The findings confirmed the importance of assessing various factors affecting ITN usage among groups of WOCBA. Both individual- and community-level factors should be considered when designing and implementing ITN programmes in Malawi.

KW - Insecticide-treated nets

KW - Malaria

KW - Malawi

KW - Multilevel

KW - Women of childbearing age

KW - Insecticide-treated nets

KW - Malaria

KW - Malawi

KW - Multilevel

KW - Women of childbearing age

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U2 - 10.1186/s12936-018-2522-z

DO - 10.1186/s12936-018-2522-z

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