期刊论文详细信息
BMC Public Health
Examining equity in access to long-lasting insecticide nets and artemisinin-based combination therapy in Anambra state, Nigeria
Amobi L Ilika1  Joseph Oranuba1  Eloka Uchegbu4  Benjamin SC Uzochukwu2  Obinna E Onwujekwe2  Chinyere O Mbachu3 
[1] Ministry of Health, Awka, Anambra State, Nigeria;Department of Health Administration and Management, Faculty of Health Sciences, University of Nigeria, Enugu, Enugu State, Nigeria;Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria;Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Enugu State, Nigeria
关键词: Artemisinin-based combination therapy;    ACT;    LLIN;    Long-lasting insecticide nets;    Equity;    Malaria;   
Others  :  1163660
DOI  :  10.1186/1471-2458-12-315
 received in 2011-10-11, accepted in 2012-04-30,  发布年份 2012
PDF
【 摘 要 】

Background

In order to achieve universal health coverage, the government of Anambra State, southeast Nigeria has distributed free Long-lasting Insecticide treated Nets (LLINs) to the general population and delivered free Artemisinin-based Combination Therapy (ACT) to pregnant women and children less than 5 years. However, the levels of coverage with LLINS and ACTs is not clear, especially coverage of different socio-economic status (SES) population groups. This study was carried out to determine the level of coverage and access to LLINs and ACTs amongst different SES groups.

Methods

A questionnaire was used to collect data from randomly selected households in 19 local government areas of the State. Selected households had a pregnant woman and/or a child less than 5 years. The lot quality assurance sampling (LQAS) methodology was used in sampling. The questionnaire explored the availability and utilization of LLINs and ACTs from 2394 households. An asset-based SES index was used to examine the level of access of LLINS and ACTs to different SES quintiles.

Results

It was found that 80.5 % of the households had an LLIN and 64.4 % of the households stated that they actually used the nets the previous night. The findings showed that 42.3 % of pregnant women who had fever within the past month received ACTs, while 37.5 % of children ≪5 years old who had malaria in the past month had received ACTs. There was equity in ownership of nets for the range 1–5 nets per household. No significant SES difference was found in use of ACTs for treatment of malaria in children under five years old and in pregnant women.

Conclusions

The free distribution of LLINs and ACTs increased household coverage of both malaria control interventions and bridged the equity gap in access to them among the most vulnerable groups.

【 授权许可】

   
2012 Mbachu et al.; licensee BioMed Central Ltd

【 预 览 】
附件列表
Files Size Format View
20150413111454125.pdf 206KB PDF download
Figure 1. 31KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]The World Bank. Malaria Prevention Program in Nigeria Aims at Universal Bed Net Coverage. Available at http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/AFRICAEXT/NIGERIAEXTN/0,,contentMDK:22178832 ~ menuPK:368902 ~ pagePK:2865066 ~ piPK:2865079 ~ theSitePK:368896,00.html. Accessed on 5/3/2012
  • [2]World Health Organization. World Health Report, 2008. Available at http://www.who.int/countries/nga/areas/malaria/en/index.html. Assessed on 14/4/2011
  • [3]Federal Ministry of Health, National Malaria Control Programme. Available at http://www.nmcpnigeria.org. Assessed on 15th April 2011
  • [4]United Nations Statistics Division. Millennium Development Goals Indicators – official list of MDG indicators. Available at http://mdgs.un.org/unsd/mdg/Host.aspx?Content = indicators/officiallist.htm. Assessed on 1/2/2012
  • [5]Eisele TP, Larsen D, Steketee RW: Protective efficacy of interventions for preventing malaria mortality in children in Plasmodium falciparum endemic areas. Int J Epidemiol 2010, 39(1):i88-i101.
  • [6]Obinna Onwujekwe, Benjamin Uzochukwu, Nkoli Ezumah, Elvis Shu: Increasing coverage of insecticide treated nets in rural Nigeria: implication of consumer knowledge, preferences and expenditures for malaria prevention. Malaria journal 2005, 4:29. BioMed Central Full Text
  • [7]The MDG Report, 2011. UN New York, 2011. Available at http://www.un.org/millenniumgoals/11_MDG%20Report_EN.pdf Access date: 2/9/2011
  • [8]National Population Commission (NPC) [Nigeria] and ICF Macro: Nigeria Demographic and Health Survey 2008. National Population Commission and ICF Macro, Abuja, Nigeria; 2009.
  • [9]Oresanya OB, Hoshen M, Sofola OT: Utilization of insecticide-treated nets by under-five children in Nigeria: Assessing progress towards the Abuja targets. Malaria Journal 2008, 7:145. BioMed Central Full Text
  • [10]Onwujekwe O, Hanson K, Fox-Rushby JA: Who buys insecticide-treated nets? Implications for increasing coverage in Nigeria. Health Policy Plan 2003, 18:279-289.
  • [11]Federal Ministry of Health, National Malaria Control Programme, Abuja, Nigeria. Strategic plan 2009–2013. Available at http://nmcpnigeria.org/f/Nigeria%20Annex%201_National%20Malaria%20Control%20Strategic%20Plan%202009-2013.pdf . Assessed on 1/2/2012
  • [12]The Global Fund. Round 8 Funding Application: Nigeria; 2008. Available at: http://portfolio.theglobalfund.org/Country/Index/NGA?lang = en#. Assessed on 20/5/2011
  • [13]Federal Ministry of Health: National Malaria and Vector Control Division. National Policy on Malaria Diagnosis and Treatment. June 2011
  • [14]Shumay Yeung, Wim Van Damme, Doung Socheat, White Nicholas J, et al.: Access to Artemisinin Combination Therapy for malaria in remote areas of Cambodia. Malaria journal 2008, 7:96. BioMed Central Full Text
  • [15]World malaria report: World Health Organization. Geneva, Switzerland, Geneva, Switzerland; 2010.
  • [16]Anambra State background information. Available on http://www.onlinenigeria.com/links/anambradv.asp. Assessed on 20/5/2011
  • [17]Hedt BL, Olives C, Pagano M, Valadez JJ: Large Country-Lot Quality Assurance Sampling: A New Method for Rapid Monitoring and Evaluation of Health, Nutrition and Population Programs at sub-National Levels. Health, Nutrition and Population, The World Bank; 2008.
  • [18]Malaria in Nigeria. Africa 2010 road map. http://www.rollbackmalaria.org/countryaction/nigeria_roadmap.html. Accessed 20th April, 2011
  • [19]Ruhago GM, Mujinja PGM, Norheim OF: Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey. [http://www.equityhealthj.com/content/10/1/29] webcite International Journal for Equity in Health 2011, 10:29. BioMed Central Full Text
  • [20]Noor AM, et al.: Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children. PLoS Med 2007, 4(8):e255.
  • [21]Grabowsky M, et al.: Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage. Bull World Health Organization 2005, 83(3):195-201.
  • [22]Eisele TP, et al.: Interpreting household survey data intended to measure insecticide-treated bednet coverage: results from two surveys in Eritrea. Malaria Journal 2006, 5:36. BioMed Central Full Text
  • [23]Adeneye AK, Jegede AS, Mafe MA, Nwokocha EE. Accessibility to and Willingness to pay for Long-lasting Insecticide Nets by most at-risk groups of malaria in Ogun State.2008 (unpublished)
  • [24]UNICEF-At a glance: Nigeria statistics. http://www.unicef.org/infobycountry/nigeria_statistics.html. Updated :2 march 2010. Accessed 20th April, 2011
  • [25]Ajayi IO, Browne EN, Garshong B: Feasibility and acceptability of artemisinin-based combination therapy for the home management of malaria in four African sites. Malaria Journal 2008, 7:6. BioMed Central Full Text
  • [26]Health Policy Research Group. Perception and practice of malaria monitoring and evaluation by health workers in Anambra State. Technical report prepared for ANMCBP. (Unpublished)
  • [27]Kangwana B, Njogu J, Wasunna B, et al.: Short report: malaria drug shortages in Kenya: a major failure to provide access to effective treatment. American Journal of Tropical Medicine and Hygiene 2009, 80(5):737-738.
  • [28]Onoka C, Onwujekwe O, Uzochukwu B: Policy Shift to Use of Artemisinin-Based Combination Therapy (Acts) in Nigeria: Do Current Socioeconomic and Geographic Differentials in Costs of Treatment for Malaria Constitute a Challenge?. Explorations in Health Economics Paper, iHEA 2007 6th World Congress; 2007.
  • [29]Sabot OJ, Mwita A, Cohen JM, et al.: Piloting the global subsidy: the impact of subsidized Artemisinin-Based Combination Therapies distributed through private drug shops in rural Tanzania. PLoS ONE 4(9)
  文献评价指标  
  下载次数:46次 浏览次数:19次