Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions

Author:

Aberese-Ako MatildaORCID,Magnussen Pascal,Ampofo Gifty D.,Tagbor Harry

Abstract

Abstract Background Improving maternal health remains a priority to the Ghanaian government. Consequently, it has implemented the World Health Organization recommendation of distributing free long-lasting insecticidal nets (LLINs) to pregnant women—one of the effective strategies to combating malaria in pregnancy. However, the burden of negative outcomes of malaria in pregnancy such as low birth weight and miscarriages is still high. This may be related to the health system, socio-cultural and economic dynamics that influence LLIN use, but their role is not well understood. This ethnographic study sought to understand health system, socio-cultural, economic and environmental dynamics in utilization of LLINs among pregnant women in two Ghanaian regions. Methods An ethnographic study design was used. In-depth interviews and conversations were conducted among health workers, pregnant women and opinion leaders. Observations were conducted in 12 communities and eight health facilities. Ethical clearance was obtained from the University of Health and Allied Sciences’ Research Ethics Committee. Nvivo 11 was used to support data coding. Data were triangulated and analysed using a thematic approach. Results Findings suggest health system, socio-cultural, economic, environmental and individual factors influenced LLIN use. Health facility readiness in stocking LLINs influenced ownership and use. Receiving appropriate information from health providers and encouragement from public officials improved LLIN use. Women with a history of LLIN use prior to becoming pregnant and women who had young children remained consistent users. Experiencing irritating effects of LLINs and preference for traditional methods to wade off mosquitoes, reduced LLIN use. Pregnant women whose household and family members used LLINs were influenced positively to use them. Gender power relations between husbands and wives influenced women’s use of LLINs. The type of housing and weather conditions contributed to inconsistent use. Staying out late for business purposes and to converse, exposed pregnant women to mosquito bites. Conclusion Giving out LLINs at facility level should be accompanied with comprehensive information, which is relevant to the socio-cultural context that women live in. Mass distribution should factor in individual and public information to promote community acceptance and proper use of ITNs. Facilities should be encouraged to constantly maintain LLINs stock in order to ensure that ANC registrants receive LLINs for use.

Funder

Wellcome Trust and the UK government

Publisher

Springer Science and Business Media LLC

Subject

Infectious Diseases,Parasitology

Reference48 articles.

1. Anchang-Kimbi JK, Elad D, Sotoing GT, Achidi EA. Coinfection with Schistosoma haematobium and Plasmodium falciparum and anaemia severity among pregnant women in Munyenge, Mount Cameroon area: a cross-sectional study. J Parasitol Res. 2017;1:6173465.

2. WHO. Factsheet on the World Malaria Report 2013. Geneva: World Health Organization, 2013. https://www.who.int/malaria/media/world_malaria_report_2013/en/. Accessed 21 Mar 2019.

3. WHO. Malaria: Fact sheet, Geneva: World Health Organization; 2018. https://www.who.int/news-room/fact-sheets/detail/malaria. Accessed 21 Mar 2019.

4. Wijesundere DA, Ramasamy R. Analysis of historical trends and recent elimination of malaria from Sri Lanka and its applicability for malaria control in other countries. Front Public Health. 2017;5:212.

5. WHO. Malaria in Pregnant Women. Geneva: World Health Organization; 2017. https://www.who.int/malaria/areas/high_risk_groups/pregnancy/en/. Accessed 10 Apr 2019.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3