Determinants of bed net use in malaria prevention for children under five years in households in Kenya: a case of Bondo subcounty

Abstract

Malaria is a global disease. The World Health Organization (WHO) latest estimates indicate that there has been a reduction in malaria mortality rates by 42% globally and 49% in the WHO Africa region between the year 2000 and 2012. The substantial reduction has been as a result of major scale-up of vector control interventions, diagnostic testing, and treatment with Artemisinin-Based Combination Therapies (ACTs). Most notably is the use of bed nets as a control recommendation against malaria. In Kenya, 25 million people out of a population of 34 million are at risk of malaria. The current bed net ownership of 0.8 per household in Kenya is below the universal access of 2 bed nets per household. This study therefore sought to investigate the determinants of bed-net use for malaria prevention in children under five years. These included household characteristics, level of education, and income of the caregivers, caregiver's perception and social support network. The study reviewed existing literature on bed net use using the socio-ecological model and identified a knowledge gap which was addressed through a cross-sectional household survey; targeting caregivers of children under five years. Descriptive research design and survey was used to collect the required information using an intervieweradministered questionnaire; which was piloted and pretested after which it was administered to all participants on consenting to be part of the research. Krejcie and Morgan’s table was used to get sample size of 368 households from the four randomly selected clusters (sub-locations). The findings and results of the study were presented in order of the research objectives. The findings were presented in frequencies and percentages. It was found out that 49% of the households had three children under the age of five years; 54% of the respondents had completed secondary education; 82% of the respondents owned a bed net even though their monthly income was less than sh5,000; 64% of the respondents who discussed the use of bed nets with their partners largely agreed that they are key to preventing malaria transmission; caregivers’ perception lean more towards believing that malaria is caused by other means than from mosquito bites. In summary, the study found out that that majority of the respondents 137 (43%) believe that caregivers’ perceptions are key to bed net use, followed by social support 65 (20%) and then household characteristics 41 (13%). The last two factors were the caregivers’ level of education and income 38 and 40 respectively; tying at 12%. Of the five objectives of the study four were found to have a significant influence on the use of bed nets namely: household characteristics, level of education, caregiver's perception and social support network. The level of education was found not to have any significant influence on the use of bed nets. It is therefore recommended that bed nets be distributed to the entire population to optimize usage; other control vectors like indoor residual spraying should be used to manage the mosquito population and members of the community need to be sensitized on malaria transmission.