Description
Introduction
Malaria remains a significant public health challenge, especially in the context of pregnancy, notably in African regions. In response, Ghana has implemented widespread distribution of Insect-Repellent Preserved Nets (IRPNs) to safeguard individuals, specifically pregnant women, against mosquito-borne diseases. This study focused on evaluating the factors, both inhibiting and encouraging associated with the utilization of insecticide-treated bed nets during pregnancy within Ghana's Middle Belt. Understanding these dynamics is critical in fortifying malaria prevention strategies tailored to expectant mothers in this region.
Methodology
This study employed a descriptive cross-sectional design utilizing a mixed methods approach. A multi-stage sampling technique was employed, with proportionate sampling determining the number of respondents from each facility. A purposive sampling technique was utilized to select partners of ANC attendees for a focus group discussion. Data analysis was conducted using IBM SPSS statistics version 25 (SPSS) and N-Vivo 12. Data triangulation techniques were employed to merge the two data sources. The association between independent variables and the dependent variable (ITN use) was examined using the Chi-square test. Subsequently, a logistic regression model was employed to determine the strength of these associations. A p-value of ≤0.05 was considered statistically significant. The results of the study were then presented in tables and charts.
Results
Among the cohort of expectant mothers, 42.3% were observed to be in the second trimester, while 21.6% were identified in the initial trimester. The largest subgroup within the population consisted of antenatal women, comprising 40.3% of the total sample. The majority of pregnant women 71.4% sleep under treated insecticide nets. Motivators for bed net use included preventing mosquito bites 83.2% and seeking privacy 6.2%. Barriers to bed net use were identified as heat 55.7% and inconvenience in sleeping under the net (3.8%). The determinants of bed net use included ownership of a bed net [aOR=7.78, 95% CI (3.44 - 17.59)], the number of bed nets owned [aOR=2.43, 95% CI (1.20 - 4.91)], and knowledge of the benefits of using bed nets [aOR=0.30, 95% CI (0.13 - 0.71)]. Other factors, such as heat associated with sleeping under insecticide-treated nets, Frequent nocturnal urination and allergic reactions to medications used in treating the ITNs.
Conclusion
There is a high rate of insecticide-treated mosquito net use among pregnant women. Household arrangements and challenges in hanging bed nets in the room were identified as barriers to net use. Socio-cultural factors, knowledge about the importance of using bed nets, and the availability of nets in the household significantly influenced bed net use. Community health nurses and midwives should consistently educate and encourage pregnant women to attend ANC sessions regularly. This can be achieved through community participation and pedagogical seminars conducted by community health nurses and midwives.
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