Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions
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 malari...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-11-01
|
| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-019-2994-5 |
| _version_ | 1818261383622426624 |
|---|---|
| author | Matilda Aberese-Ako Pascal Magnussen Gifty D. Ampofo Harry Tagbor |
| author_facet | Matilda Aberese-Ako Pascal Magnussen Gifty D. Ampofo Harry Tagbor |
| author_sort | Matilda Aberese-Ako |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T18:46:22Z |
| format | Article |
| id | doaj.art-a5787e116a054a17af0ff28c45b7f3b0 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-12T18:46:22Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-a5787e116a054a17af0ff28c45b7f3b02022-12-22T00:15:31ZengBMCMalaria Journal1475-28752019-11-0118111310.1186/s12936-019-2994-5Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regionsMatilda Aberese-Ako0Pascal Magnussen1Gifty D. Ampofo2Harry Tagbor3University of Health and Allied SciencesFaculty of Health and Medical Sciences, Centre for Medical Parasitology, University of CopenhagenUniversity of Health and Allied SciencesUniversity of Health and Allied SciencesAbstract 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.http://link.springer.com/article/10.1186/s12936-019-2994-5GhanaLLINsMalaria in pregnancyHealth facilitiesHealth workersPregnant women |
| spellingShingle | Matilda Aberese-Ako Pascal Magnussen Gifty D. Ampofo Harry Tagbor Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions Malaria Journal Ghana LLINs Malaria in pregnancy Health facilities Health workers Pregnant women |
| title | Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions |
| title_full | Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions |
| title_fullStr | Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions |
| title_full_unstemmed | Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions |
| title_short | Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions |
| title_sort | health system socio cultural economic environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two ghanaian regions |
| topic | Ghana LLINs Malaria in pregnancy Health facilities Health workers Pregnant women |
| url | http://link.springer.com/article/10.1186/s12936-019-2994-5 |
| work_keys_str_mv | AT matildaabereseako healthsystemsocioculturaleconomicenvironmentalandindividualfactorsinfluencingbednetuseinthepreventionofmalariainpregnancyintwoghanaianregions AT pascalmagnussen healthsystemsocioculturaleconomicenvironmentalandindividualfactorsinfluencingbednetuseinthepreventionofmalariainpregnancyintwoghanaianregions AT giftydampofo healthsystemsocioculturaleconomicenvironmentalandindividualfactorsinfluencingbednetuseinthepreventionofmalariainpregnancyintwoghanaianregions AT harrytagbor healthsystemsocioculturaleconomicenvironmentalandindividualfactorsinfluencingbednetuseinthepreventionofmalariainpregnancyintwoghanaianregions |