Skip to main content
Top
Published in: Malaria Journal 1/2016

Open Access 01-12-2016 | Research

Equity in long-lasting insecticidal nets and indoor residual spraying for malaria prevention in a rural South Central Ethiopia

Authors: Alemayehu Hailu, Bernt Lindtjørn, Wakgari Deressa, Taye Gari, Eskindir Loha, Bjarne Robberstad

Published in: Malaria Journal | Issue 1/2016

Login to get access

Abstract

Background

While recognizing the recent achievement in the global fight against malaria, the disease remains a challenge to health systems in low-income countries. Beyond widespread consensuses about prioritizing malaria prevention, little is known about the prevailing status of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) across different levels of wealth strata. The aim of this study was to evaluate the socioeconomic related dimension of inequalities in malaria prevention interventions.

Methods

This study was conducted in July–August 2014 in Adami Tullu district in the South-central Ethiopia, among 6069 households. A cross-sectional data were collected on household characteristics, LLIN ownership and IRS coverage. Principal component analysis technique was used for ranking households based on socioeconomic position. The inequality was measured using concentration indices and concentration curve. Decomposition method was employed in order to quantify the percentage contribution of each socioeconomic related variable on the overall inequality.

Results

The proportion of households with at least one LLIN was 11.6 % and IRS coverage was 72.5 %. The Erreygers normalized concentration index was 0.0627 for LLIN and 0.0383 for IRS. Inequality in LLIN ownership was mainly associated with difference in housing situation, household size and access to mass-media and telecommunication service.

Conclusion

Coverage of LLIN was low and significant more likely to be owned by the rich households, whereas houses were sprayed equitably. The current mass free distribution of LLINs should be followed by periodic refill based on continuous monitoring data.
Literature
1.
go back to reference World Health Organization. World malaria report 2014. Geneva: World Health Organization; 2014. World Health Organization. World malaria report 2014. Geneva: World Health Organization; 2014.
2.
go back to reference MoH. National malaria programme monitoring and evaluation plan 2014–2020. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2014. MoH. National malaria programme monitoring and evaluation plan 2014–2020. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2014.
3.
go back to reference WHO. World malaria report 2013. Geneva: World Health Organization; 2013. WHO. World malaria report 2013. Geneva: World Health Organization; 2013.
4.
go back to reference WHO. World malaria report 2015. Geneva: World Health Organization; 2015. WHO. World malaria report 2015. Geneva: World Health Organization; 2015.
5.
go back to reference Olana D, Chibsa S, Teshome D, Mekasha A, Graves PM, Reithinger R. Malaria, Oromia regional state, Ethiopia, 2001–2006. Emerg Infect Dis. 2011;17:1336–7.CrossRefPubMedPubMedCentral Olana D, Chibsa S, Teshome D, Mekasha A, Graves PM, Reithinger R. Malaria, Oromia regional state, Ethiopia, 2001–2006. Emerg Infect Dis. 2011;17:1336–7.CrossRefPubMedPubMedCentral
6.
go back to reference Bekele D, Belyhun Y, Petros B, Deressa W. Assessment of the effect of insecticide-treated nets and indoor residual spraying for malaria control in three rural kebeles of Adami Tulu District, South Central Ethiopia. Malar J. 2012;11:127.CrossRefPubMedPubMedCentral Bekele D, Belyhun Y, Petros B, Deressa W. Assessment of the effect of insecticide-treated nets and indoor residual spraying for malaria control in three rural kebeles of Adami Tulu District, South Central Ethiopia. Malar J. 2012;11:127.CrossRefPubMedPubMedCentral
7.
go back to reference Gari T, Kenea O, Loha E, Deressa W, Hailu A, Balkew M, et al. Malaria incidence and entomological findings in an area targeted for a cluster-randomized controlled trial to prevent malaria in Ethiopia: results from a pilot study. Malar J. 2016;15:145.CrossRefPubMedPubMedCentral Gari T, Kenea O, Loha E, Deressa W, Hailu A, Balkew M, et al. Malaria incidence and entomological findings in an area targeted for a cluster-randomized controlled trial to prevent malaria in Ethiopia: results from a pilot study. Malar J. 2016;15:145.CrossRefPubMedPubMedCentral
8.
go back to reference Ghebreyesus T, Deressa W, Witten KH, Getachew A, Seboxa T. Malaria. In: Berhane Y, Haile-Mariam D, Kloos H, editors. Epidemiology and ecology of health and disease in Ethiopia. 1st ed. Addis Ababa: Shama PLC; 2006. p. 556–76. Ghebreyesus T, Deressa W, Witten KH, Getachew A, Seboxa T. Malaria. In: Berhane Y, Haile-Mariam D, Kloos H, editors. Epidemiology and ecology of health and disease in Ethiopia. 1st ed. Addis Ababa: Shama PLC; 2006. p. 556–76.
9.
go back to reference Gallup JL, Sachs J. The economic burden of malaria. Centre for international development at Harvard. Am J Trop Med Hyg. 2001;64:85–96.PubMed Gallup JL, Sachs J. The economic burden of malaria. Centre for international development at Harvard. Am J Trop Med Hyg. 2001;64:85–96.PubMed
10.
11.
12.
go back to reference Flaxman AD, Fullman N, Otten MW Jr, Menon M, Cibulskis RE, Ng M, et al. Rapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: a systematic synthesis of supply, distribution, and household survey data. PLoS Med. 2010;7:e1000328.CrossRefPubMedPubMedCentral Flaxman AD, Fullman N, Otten MW Jr, Menon M, Cibulskis RE, Ng M, et al. Rapid scaling up of insecticide-treated bed net coverage in Africa and its relationship with development assistance for health: a systematic synthesis of supply, distribution, and household survey data. PLoS Med. 2010;7:e1000328.CrossRefPubMedPubMedCentral
13.
go back to reference CSA & ORC Macro. Ethiopia demographic and health survey 2005. Addis Ababa and Calverton: Central Statistical Agency and ORC Macro; 2006. CSA & ORC Macro. Ethiopia demographic and health survey 2005. Addis Ababa and Calverton: Central Statistical Agency and ORC Macro; 2006.
14.
go back to reference Jima D, Getachew A, Bilak H, Steketee RW, Emerson PM, Graves PM, et al. Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions. Malar J. 2010;9:58.CrossRefPubMedPubMedCentral Jima D, Getachew A, Bilak H, Steketee RW, Emerson PM, Graves PM, et al. Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions. Malar J. 2010;9:58.CrossRefPubMedPubMedCentral
15.
go back to reference CSA & ORC Macro. Ethiopia demographic and health survey 2011. Addis Ababa and Calverton: Central Statistical Agency and ORC Macro; 2011. CSA & ORC Macro. Ethiopia demographic and health survey 2011. Addis Ababa and Calverton: Central Statistical Agency and ORC Macro; 2011.
16.
go back to reference MoH. Ethiopia national malaria indicator survey 2011. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2012. MoH. Ethiopia national malaria indicator survey 2011. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2012.
17.
go back to reference PMI. Ethiopia malaria operational plan FY 2015. Addis Ababa: President’s Malaria Initiative USAID; 2015. PMI. Ethiopia malaria operational plan FY 2015. Addis Ababa: President’s Malaria Initiative USAID; 2015.
18.
go back to reference Heggenhougen HK, Hackethal V, Vivek P. The behavioural and social aspects of malaria and its control: an introduction and annotated bibliography. Geneva: World Health Organization; 2003. p. 147–52. Heggenhougen HK, Hackethal V, Vivek P. The behavioural and social aspects of malaria and its control: an introduction and annotated bibliography. Geneva: World Health Organization; 2003. p. 147–52.
19.
go back to reference Worrall E, Basu S, Hanson K. Is malaria a disease of poverty? A review of the literature. Trop Med Int Health. 2005;10:1047–59.CrossRefPubMed Worrall E, Basu S, Hanson K. Is malaria a disease of poverty? A review of the literature. Trop Med Int Health. 2005;10:1047–59.CrossRefPubMed
20.
go back to reference Filmer D. Fever and its treatment among the more and less poor in sub-Saharan Africa. Health Policy Plan. 2005;20:337–46.CrossRefPubMed Filmer D. Fever and its treatment among the more and less poor in sub-Saharan Africa. Health Policy Plan. 2005;20:337–46.CrossRefPubMed
21.
go back to reference Ministry of Health. Health sector transformation plan 2008–2012 EFY. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2015. Ministry of Health. Health sector transformation plan 2008–2012 EFY. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2015.
22.
go back to reference Cookson R, Drummond M, Weatherly H. Explicit incorporation of equity considerations into economic evaluation of public health interventions. Health Econ Policy Law. 2009;4:231–45.CrossRefPubMed Cookson R, Drummond M, Weatherly H. Explicit incorporation of equity considerations into economic evaluation of public health interventions. Health Econ Policy Law. 2009;4:231–45.CrossRefPubMed
23.
go back to reference Onwujekwe O, el Malik F, Mustafa SH, Mnzavaa A. Do malaria preventive interventions reach the poor? Socioeconomic inequities in expenditure on and use of mosquito control tools in Sudan. Health Policy Plan. 2006;21:10–6.CrossRefPubMed Onwujekwe O, el Malik F, Mustafa SH, Mnzavaa A. Do malaria preventive interventions reach the poor? Socioeconomic inequities in expenditure on and use of mosquito control tools in Sudan. Health Policy Plan. 2006;21:10–6.CrossRefPubMed
24.
go back to reference Barat LM, Palmer N, Basu S, Worrall E, Hanson K, Mills A. Do malaria control interventions reach the poor? A view through the equity lens. Am J Trop Med Hyg. 2004;71:174–8.PubMed Barat LM, Palmer N, Basu S, Worrall E, Hanson K, Mills A. Do malaria control interventions reach the poor? A view through the equity lens. Am J Trop Med Hyg. 2004;71:174–8.PubMed
25.
go back to reference Deressa W, Loha E, Balkew M, Hailu A, Gari T, Kenea O, et al. Combining long-lasting insecticidal nets and indoor residual spraying for malaria prevention in Ethiopia: study protocol for a cluster randomized controlled trial. Trials. 2016;17:20.CrossRefPubMedPubMedCentral Deressa W, Loha E, Balkew M, Hailu A, Gari T, Kenea O, et al. Combining long-lasting insecticidal nets and indoor residual spraying for malaria prevention in Ethiopia: study protocol for a cluster randomized controlled trial. Trials. 2016;17:20.CrossRefPubMedPubMedCentral
26.
go back to reference Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21:459–68.CrossRefPubMed Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21:459–68.CrossRefPubMed
27.
go back to reference Filmer D, Pritchett LH. Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of India. Demography. 2001;38:115–32.PubMed Filmer D, Pritchett LH. Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of India. Demography. 2001;38:115–32.PubMed
28.
go back to reference Wagstaff A, Paci P, van Doorslaer E. On the measurement of inequalities in health. Soc Sci Med. 1991;33:545–57.CrossRefPubMed Wagstaff A, Paci P, van Doorslaer E. On the measurement of inequalities in health. Soc Sci Med. 1991;33:545–57.CrossRefPubMed
29.
go back to reference O’Donnell O. Analyzing health equity using household survey data a guide to techniques and their implementation. Washington: World Bank; 2008. O’Donnell O. Analyzing health equity using household survey data a guide to techniques and their implementation. Washington: World Bank; 2008.
31.
go back to reference Wagstaff A, Watanabe N, Doorslaer E. On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. Washington: World Bank; 2001.CrossRef Wagstaff A, Watanabe N, Doorslaer E. On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. Washington: World Bank; 2001.CrossRef
32.
go back to reference StataCorp. Stata statistical software: release 14. College Station: StataCorp LP; 2015. StataCorp. Stata statistical software: release 14. College Station: StataCorp LP; 2015.
33.
go back to reference Woyessa A, Deressa W, Ali A, Lindtjorn B. Ownership and use of long-lasting insecticidal nets for malaria prevention in Butajira area, south-central Ethiopia: complex samples data analysis. BMC Public Health. 2014;14:99.CrossRefPubMedPubMedCentral Woyessa A, Deressa W, Ali A, Lindtjorn B. Ownership and use of long-lasting insecticidal nets for malaria prevention in Butajira area, south-central Ethiopia: complex samples data analysis. BMC Public Health. 2014;14:99.CrossRefPubMedPubMedCentral
34.
go back to reference Teklemariam Z, Awoke A, Dessie Y, Weldegebreal F. Ownership and utilization of insecticide-treated nets (ITNs) for malaria control in Harari National Regional State Eastern Ethiopia. Pan Afr Med J. 2015;21:52.CrossRefPubMedPubMedCentral Teklemariam Z, Awoke A, Dessie Y, Weldegebreal F. Ownership and utilization of insecticide-treated nets (ITNs) for malaria control in Harari National Regional State Eastern Ethiopia. Pan Afr Med J. 2015;21:52.CrossRefPubMedPubMedCentral
35.
36.
go back to reference Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, et al. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg. 2003;68:121–7.PubMed Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, et al. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg. 2003;68:121–7.PubMed
37.
go back to reference Andrew D, Oladele A, Pieter S, Francis S. Preventive or curative treatment of malaria? Evidence from agricultural workers in Nigeria. Washington: International Food Policy Research Institute; 2012. Andrew D, Oladele A, Pieter S, Francis S. Preventive or curative treatment of malaria? Evidence from agricultural workers in Nigeria. Washington: International Food Policy Research Institute; 2012.
38.
39.
go back to reference Ministry of Health. National malaria guidelines. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2012. Ministry of Health. National malaria guidelines. Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health; 2012.
40.
go back to reference World Bank. Ethiopia poverty assessment 2014. Washington: World Bank Group; 2015. World Bank. Ethiopia poverty assessment 2014. Washington: World Bank Group; 2015.
Metadata
Title
Equity in long-lasting insecticidal nets and indoor residual spraying for malaria prevention in a rural South Central Ethiopia
Authors
Alemayehu Hailu
Bernt Lindtjørn
Wakgari Deressa
Taye Gari
Eskindir Loha
Bjarne Robberstad
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2016
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-016-1425-0

Other articles of this Issue 1/2016

Malaria Journal 1/2016 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.