Use of insecticide-treated nets by pregnant and childbearing-age women: Action research in Southern Nigeria

Abstract

Background/Aims Malaria in pregnancy is a major public health problem in Nigeria, along with high maternal morbidity, and fetal and neonatal mortality rates. Strategies for the control of malaria include the use of insecticide-treated bed nets (ITNs). Although some agencies distribute ITNs free of charge, some nets are not being used appropriately by pregnant women and other women of childbearing age. This study sought to empower pregnant women and women of childbearing age to take action to prevent malaria through the proper use of ITNs. Methods An action research design was used, which comprises cycles of fact-finding, planning and action, and reflection and evaluation. In collaboration with the action research group, 26 pregnant women or women of childbearing age were interviewed to gain an understanding of their perception of malaria and their use of ITNs. Seven community health extension workers and two primary health care coordinators were also interviewed. Observation sessions were held with eight women in their vegetable farms. Two focus group discussions were held with eight midwives and seven husbands. A total of 71 general participants and 13 action research group members were involved in the study. Data were thematically analysed and emphasis was laid on data that would promote learning and change. Conclusions The study revealed poor knowledge of the cause of malaria, non-compliance with the proper use of ITNs, diversionary use of ITNs and poor health intervention monitoring. Actions undertaken to empower the women towards the effective use of ITNs included community education, prenatal education, and advocacy discussions with government and relevant non-governmental agencies. Experiences gained from the study were reviewed and consolidated, and sustainability of actions planned.