Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria

Malaria Journal

Research

Elizabeth Patton¹  Samantha Dovey¹  Yazoume Ye¹  Albert Kilian²  Erin Eckert³ 

[1] ICF International, 11785 Beltsville Drive, Suite 300, 20705, Calverton, MD, USA;Malaria Consortium, Development House, 56-64 Leonard Street, EC2A 4LT, London, UK;The US 's President Malaria Initiative/USAID, Washington, USA;

关键词: Malaria;    Concentration Index;    Wealth Quintile;    Distribution Campaign;    Mass Distribution Campaign;   

DOI  :  10.1186/1475-2875-11-32

 received in 2011-07-03, accepted in 2012-02-01,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundInsecticide-treated nets (ITNs) are effective tools for malaria prevention and can significantly reduce severe disease and mortality due to malaria, especially among children under five in endemic areas. However, ITN coverage and use remain low and inequitable among different socio-economic groups in sub-Saharan Africa, particularly in Nigeria. Several strategies have been proposed to increase coverage and use and reduce inequity in Nigeria, including free distribution campaigns recently conducted by the Nigerian federal government. Using data from the first post-campaign survey, the authors investigated the effect of the mass free distribution campaigns in achieving equity in household ownership and use of ITNs.MethodsA post-campaign survey was undertaken in November 2009 in northern Nigeria to assess the effect of the campaigns in addressing equity across different socio-economic groups. The survey included 987 households randomly selected from 60 clusters in Kano state. Using logistic regression and the Lorenz concentration curve and index, the authors assessed equity in ITN coverage and use.ResultsITN ownership coverage increased from 10% before the campaigns to 70%-a more than fivefold increase. The campaigns reduced the ownership coverage gap by 75%, effectively reaching parity among wealth quintiles (Concentration index 0.02, 95% CI (-0.02 ; 0.05) versus 0.21 95%CI (0.08 ; 0.34) before the campaigns). ITN use (individuals reporting having slept under an ITN the night before the survey visit) among individuals from households owning at least one ITN, was 53.1% with no statistically significant difference between the lowest, second, third and fourth wealth quintiles and the highest wealth quintile (lowest: odds ratio (OR) 0.87, 95% confidence interval (CI) (0.67 ; 1.13); second: OR 0.85, 95% CI (0.66 ; 1.24); third: OR 1.10 95% CI (0.86 ; 1.4) and fourth OR 0.91 95% CI (0.72 ; 1.15).ConclusionThe campaign had a significant impact by increasing ITN coverage and reducing inequity in ownership and use. Free ITN distribution campaigns should be sustained to increase equitable coverage. These campaigns should be supplemented with other ITN distribution strategies to cover newborns and replace aging nets.

【 授权许可】

CC BY   
© Ye et al; licensee BioMed Central Ltd. 2012