TY - JOUR
T1 - Ideational factors associated with consistent use of insecticide-treated nets
T2 - a multi-country, multilevel analysis
AU - Babalola, Stella
AU - Kumoji, Kuor
AU - Awantang, Grace N.
AU - Oyenubi, Olamide A.
AU - Toso, Michael
AU - Tsang, Samantha
AU - Bleu, Therese
AU - Achu, Dorothy
AU - Hedge, Judith
AU - Schnabel, David C.
AU - Cash, Shelby
AU - Van Lith, Lynn M.
AU - McCartney-Melstad, Anna C.
AU - Nkomou, Yannick
AU - Dosso, Abdul
AU - Lahai, Wani
AU - Hunter, Gabrielle C.
N1 - Funding Information:
The authors would like to thank Dalan Development Consultants in Sierra Leone, Institute for Research Socio-economic Development and Communication (IRESCO) in Cameroon, and the Omedia Group in Côte d’Ivoire for conducting the field work, as well as all the research participants who welcomed us into their households and shared their malaria-related knowledge and practices with us. The authors would also like to thank Kevin Griffith and Jessica Butts from the Centers for Disease and Control, and Donald Dickerson, Blaise Kouadio, Avery Avrakotos, from USAID for their support of the activities that led to the development of this manuscript and for their insightful feedback on the manuscript. The authors would like to acknowledge the late Dr. Smith, former NMCP Sierra Leone programme manager, for his contributions to this manuscript.
Funding Information:
This work, through Breakthrough ACTION at the Johns Hopkins Center for Communication Programs, is funded by the Global Health Bureau of the United States Agency for International Development (USAID) and the U.S. President’s Malaria Initiative (PMI) under the terms of Cooperative Agreement No. AID-OAA-A-17-00017. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID, PMI, or the United States Government.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Malaria remains a major cause of morbidity and mortality in sub-Saharan Africa. Using insecticide-treated nets (ITNs) every night, year-round is critical to maximize protection against malaria. This study describes sociodemographic, psychosocial, and household factors associated with consistent ITN use in Cameroon, Côte d’Ivoire and Sierra Leone. Methods: Cross-sectional household surveys employed similar sampling procedures, data collection tools, and methods in three countries. The survey sample was nationally representative in Côte d’Ivoire, representative of the North and Far North regions in Cameroon, and representative of Bo and Port Loko districts in Sierra Leone. Analysis used multilevel logistic regression and sociodemographic, ideational, and household independent variables among households with at least one ITN to identify correlates of consistent ITN use, defined as sleeping under an ITN every night the preceding week. Findings: Consistent ITN use in Côte d’Ivoire was 65.4%, 72.6% in Cameroon, and 77.1% in Sierra Leone. While several sociodemographic and ideational variables were correlated with consistent ITN use, these varied across countries. Multilevel logistic regression results showed perceived self-efficacy to use ITNs and positive attitudes towards ITN use were variables associated with consistent use in all three countries. The perception of ITN use as a community norm was positively linked with consistent use in Cameroon and Côte d’Ivoire but was not significant in Sierra Leone. Perceived vulnerability to malaria was positively linked with consistent use in Cameroon and Sierra Leone but negatively correlated with the outcome in Côte d’Ivoire. Household net sufficiency was strongly and positively associated with consistent use in all three countries. Finally, the findings revealed strong clustering at the household and enumeration area (EA) levels, suggesting similarities in net use among respondents of the same EA and in the same household. Conclusions: There are similarities and differences in the variables associated with consistent ITN use across the three countries and several ideational variables are significant. The findings suggest that a social and behaviour change strategy based on the ideation model is relevant for increasing consistent ITN use and can inform specific strategies for each context. Finally, ensuring household net sufficiency is essential.
AB - Background: Malaria remains a major cause of morbidity and mortality in sub-Saharan Africa. Using insecticide-treated nets (ITNs) every night, year-round is critical to maximize protection against malaria. This study describes sociodemographic, psychosocial, and household factors associated with consistent ITN use in Cameroon, Côte d’Ivoire and Sierra Leone. Methods: Cross-sectional household surveys employed similar sampling procedures, data collection tools, and methods in three countries. The survey sample was nationally representative in Côte d’Ivoire, representative of the North and Far North regions in Cameroon, and representative of Bo and Port Loko districts in Sierra Leone. Analysis used multilevel logistic regression and sociodemographic, ideational, and household independent variables among households with at least one ITN to identify correlates of consistent ITN use, defined as sleeping under an ITN every night the preceding week. Findings: Consistent ITN use in Côte d’Ivoire was 65.4%, 72.6% in Cameroon, and 77.1% in Sierra Leone. While several sociodemographic and ideational variables were correlated with consistent ITN use, these varied across countries. Multilevel logistic regression results showed perceived self-efficacy to use ITNs and positive attitudes towards ITN use were variables associated with consistent use in all three countries. The perception of ITN use as a community norm was positively linked with consistent use in Cameroon and Côte d’Ivoire but was not significant in Sierra Leone. Perceived vulnerability to malaria was positively linked with consistent use in Cameroon and Sierra Leone but negatively correlated with the outcome in Côte d’Ivoire. Household net sufficiency was strongly and positively associated with consistent use in all three countries. Finally, the findings revealed strong clustering at the household and enumeration area (EA) levels, suggesting similarities in net use among respondents of the same EA and in the same household. Conclusions: There are similarities and differences in the variables associated with consistent ITN use across the three countries and several ideational variables are significant. The findings suggest that a social and behaviour change strategy based on the ideation model is relevant for increasing consistent ITN use and can inform specific strategies for each context. Finally, ensuring household net sufficiency is essential.
KW - Consistent use
KW - ITN
KW - Ideational variables
KW - Multilevel
KW - SBC
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U2 - 10.1186/s12936-022-04384-3
DO - 10.1186/s12936-022-04384-3
M3 - Article
C2 - 36474206
AN - SCOPUS:85143401146
SN - 1475-2875
VL - 21
JO - Malaria journal
JF - Malaria journal
IS - 1
M1 - 374
ER -