|Author(s)||Martina Ezeama1, Felix Ezeamah2
|Affiliation(s)||1Nursing science, Imo State University Owerri Nigeria, 2Private Practictioner, Ndukwu Hospital Amaifeke Orlu Imo State , Owerri, Nigeria,|
|Country - ies of focus||Nigeria|
|Relevant to the conference tracks||Education and Research|
|Summary||The study was carried out to determine factors militating against utilization of insecticide treated nets by pregnant women. This was based on the background of the study which reflected low usage of ITNS by pregnant women in the study setting. A total 201 pregnant women were interviewed using questionnaire. Overall results showed that majority were aware of the insecticide treated net but usage was low. Most respondents reported experiencing excessive heat under net and were afraid of the chemical used in producing the net. Findings suggest the need for an intensive public enlightenment campaign to dispel fear of chemicals used in treating the ITNs and heat produced by ITNs to encourage use among pregnant women.|
|Background||Malaria infestation during pregnancy has been associated with persistent high maternal and childhood morbidity and mortality among pregnant women especially in Nigeria were malaria is highly endemic. Malaria accounts for 11% of maternal death, 70% of morbidity in pregnant women and is responsible for 63% of all clinic attendances in Nigeria. It causes 25% of infant mortality and 30% of all childhood deaths. Malaria during pregnancy accounts for up to 15% of maternal anemia and 5-14% of low birth weight (Safe motherhood fact sheet 19). As a result the World Health Organization (WHO) launched Roll Back Malaria (RBM) initiative in 1998 with a major focus on the prevention & management of malaria during pregnancy by using insecticide treated nets (ITNs) among other measures. Although malaria is preventable, easily treated and curable, it assumes a deadly dimension when it occurs in pregnancy and it is not promptly managed.|
|Objectives||The broad objective of this study was to determine factors militating against the utilization of insecticide treated net among pregnant women attending the antenatal clinics (ANC) in a tertiary health facility in Imo State Nigeria. Other objectives include:
To determine the level of awareness of insecticide treated nets among pregnant women.
Ascertain the frequency of the use of insecticide treated nets among pregnant women.
Determine the measures that promote the use of ITNs by pregnant women.
Determine the influence of socio-demographic characteristics of pregnant women towards the use of insecticide treated nets.
|Methodology||The study was descriptive in nature and because of its focus on the clinics within the teaching hospital, was a case study of the factors militating against the utilization of insecticide treated net among pregnant women attending antenatal care in teaching hospital Orlu, Imo State Nigeria. In the course of clinical experience at the antenatal clinic (ANC) and community posting, the researcher noticed that the usage of insecticide treated nets (ITNs) among pregnant women is still not encouraging despite awareness being created about the importance of this cost-effective and efficient method of malaria prevention and control.
The researcher conducted a study to ascertain the level of usage of insecticide treated mosquito nets (ITNs) among pregnant women attending antenatal (ANC) in Imo state teaching hospital and also the factors militating usage by asking the following questions:
What is the level of awareness of insecticide treated nets among pregnant women.
To what extent are insecticide treated nets used by pregnant women.
What are the factors influencing the use of insecticide treated nets among pregnant women.
What are the measures that could promote the use of insecticide treated nets by pregnant women.
What is the influence of socio-demographic characteristics of the respondents towards the use of insecticide treated nets. The study was approved by the hospital Human Research Ethic Committee and informed consent was obtained from the patients. The sample size used was based on a simple proportion and prevalence of 13% from previous study. Data were collected on a pretested research administered structured questionnaire and analyzed using SPSS version 16 statistical software. Information collected included socio-demographic data, level of awareness and usage of ITNs, factors militating against usage and measures that could promote the use of ITNs by pregnant women. Descriptive statistics was obtained for quantitative variables while frequencies and percentages were used to present categorical variables. Chi Square statistical tests were carried out where applicable with the level of significance set at p < 0.05.
|Results||A total of 201 pregnant women were interviewed. Their ages ranged between 18 and 50 years with mean of 27% years. The majority 191(95%) were married, 150 (74.6%) had attained tertiary education and 137(68.2%) were multigravida while 64(31.8%) primigravida, 155(77.1%) were aware that insecticide treated nets (ITNs) could prevent malaria in pregnancy, but less than half 91(45.39%) of them were using ITNs. Their major source of information about ITN's was at the ANC. 71(35.3%) of pregnant women were in possession of ITNs. Constraints to the use of ITNs were 98(48.8%) and included not using ITNs because of the heat they experienced under the ITNs, 64(31.8%) reported fear of the chemicals used in treating the net, 24(11.9%) indicated non-availability of ITNs and 17(8.5%) lacked knowledge on how to install the nets. Measures to increase the use of ITNs by respondents included: the majority 91(45.3%) indicated the increase in ITNs awareness campaign, 74(36.8%) increase availability of nets, and 46(22.9%) indicated the need for increased education on how to install the net. There was no statistical significance between marital status (P=0731, Parity (P=0.538), level of education (P=0.269) and usage of ITNs.|
|Conclusion||Although there was a high awareness about ITNs, the use of ITNs was low. Experiences of excessive heat and fear of the chemical used in treating the nets are major constraints. Intensive public enlightenment to dispel misconception about fear of the chemical used in treating the net, excessive heat and availability of ITNs may encourage the use of ITNs among pregnant women. The study is significant as it has pointed out factors that militate against the use insecticide treated nets by pregnant women. This study will equip health personals or care providers with more knowledge on how to create more awareness to the populace on the use of ITNs and will also help government and policy makers through supplying the populace with enough ITNs thereby reducing high mortality and morbidity rate. It is recommended that the major challenges of low usage such as fear of chemicals, excessive heat and inadequate supply be seriously addressed to encourage the use of insecticide treated nets by pregnant women to prevent malaria during pregnancy.|