The role of perceived threat and self-efficacy in the use of Insecticide Treated Bednets (ITNs) to prevent malaria among pregnant women in Tororo District, Uganda

Abstract

Background Despite increased coverage of Insecticide Treated Nets (ITNs) due to free distribution programs, ITN use in Uganda remains sub optimal among pregnant women. This study explored the relationship between constructs of a theoretical framework and Net use. Objective The study examined the role of constructs from the Extended Parallel Process Model (EPPM) in determining ITN use amongst pregnant women 15–49 years in Tororo district, Uganda. Methods A cross-sectional study using a systematic sample was conducted among 230 pregnant women attending antenatal care. The questionnaire was administered by trained research assistants. Analysis was conducted to establish the relationship between ITN use and perceived susceptibility, severity, self-efficacy and response efficacy. Results Over three-quarters (78.6%) reported using ITNs the night before the study while 49.78% reported consistent Net use. High self-efficacy (AOR 9.48 95%CI 3.34–26.91) was associated with ITN use the previous night and consistent use. High perceived threat was associated with consistent ITN use (AOR 2.78, 95%CI 1.16–6.67) but not with Net use the previous night. Conclusion Self-efficacy was an important predictor of ITN use, as well as high levels of fear, as measured through perceived threat, which was associated with consistent ITN use, but not ITN use the previous night. Social and behavior change communication interventions should focus on improving self-efficacy to use ITNs.