Abstract
Background
Past studies have revealed significant relationships between gender and health outcomes, including malaria prevention. Women tend to exhibit more positive health-seeking behaviours than men. Thus, gender dynamics can influence the adoption of measures to prevent infections, including malaria. This study investigated the role of women’s empowerment indicators in adopting insecticide-treated nets (ITNs) to control malaria in six sub-Saharan African (SSA) countries.
Methods
The data for the study were based on the demographic and health survey (DHS) datasets for the respective countries: Ghana, Uganda, Nigeria, Cameroon, Togo and Burkina Faso. The six countries' datasets were merged, cleaned, harmonized and recoded where necessary. The Pearson chi-square independence test was used to examine the association between ITN use and six women’s empowerment indicators: (1) employment or earning (economic), (2) household decision-making, (3) absence of domestic violence, (4) ownership of property, (5) educational attainment and (6) financial inclusion. Binary logistic regression was employed to examine factors associated with ITN use. SPSSsoftware was used for managing and analysing the data.
Results
Among the 116,088 women surveyed, 60,605 (52.2%) had slept under ITNs the night before the survey. Controlling for individual characteristics and the adoption of ITNs in malaria prevention, the odds of using ITNs improved among women who had high decision-making autonomy (AOR = 1.21; CI = 1.07–1.35; P < 0.05), financial inclusion (AOR = 1.16; CI = 1.08–1.23; P < 0.05), who earned the same as their husbands or partners (AOR = 1.07; CI = 0.98–1.17; P < 0.05), and who had a primary education (AOR = 1.31; CI = 1.17–1.47). The results show that women’s empowerment indicators significantly influenced ITN use. Women’s decision-making autonomy, education, financial inclusion and freedom from domestic violence were positively associated with the uptake of ITNs.
Conclusion
Women’s empowerment is an important element in adopting measures to control malaria infection. Improved women’s empowerment was associated with increased use of ITNs. Efforts to address the challenges associated with malaria elimination and prevention in SSA countries should consider an intentional focus on women’s empowerment indicators for more successful outcomes.