Benefit incidence analysis of free insecticide treated nets distribution in urban and rural communities of Enugu state, South East Nigeria

Abstract

Background: Malaria is a leading cause of mortality as well as a barrier to economic and social development in developing countries. The use of insecticide‑treated nets (ITNs) for malaria vector control is effective in controlling malaria attacks in pregnant women and under‑5 children. The Nigerian government, in its bid to achieve the Millennium Development Goal (MDG) 4 and 5 distributes free ITNs to pregnant mothers and under‑five children in the Roll Back Malaria programme (RBM).
Aim: This study compared the benefit incidence analysis of this government program between urban and rural areas.
Materials and Methods: Pretested, semi‑structured questionnaires were administered to 150 pregnant women and also 150 mothers of under‑5 children, who were randomly selected from each of the two communities (rural and urban) from a local government area (LGA) in Enugu state, Nigeria. The study was conducted within the rainy season periods (March–August) of 2008. The information obtained included some socio‑economic variables, accessibility, usage and benefits of usage of ITNs. Data entry and analyses were done using the Statistical Package for Social Sciences (SPSS) version 15.0(Chicago IL, USA). Student’s t‑test and Chi‑square were used for comparison where appropriate. Significant values were taken as P value. Value of less than 0.05 was considered significant.
Results: The respondents’ mean monthly expenditures on food utilities and anti‑malarials in the rural area and urban areas were N266.1 (74.02), range (143.3-395) and N473 (90) range (380-495.7) respectively (P < 0.001). Within each socio‑economic stratum (SES), the average monthly expenditure in the urban community was higher than that of the rural community except for least poor SES (P < 0.05). For the urban community, 106 (71.6%) respondents used ITNs as against 99 (66.9%) in the rural community [P = 0.778, OR = 1.3 (95% CI: 0.76, 2.05)]. Also, ITNs were always accessible to 112 (75.7%) and 54 (36.5%) respondents in the urban and rural communities respectively [P < 0.001, OR = 5.4 (95% CI: 3.28, 8.96)]. In the urban community, 130 (87.7%) respondents expressed some benefit from ITNs as against 123 (83.1%) respondents from the rural community [P = 0.258, OR = 1.5 (95% CI: 0.76, 2.28)].
Conclusion: Most pregnant women and mothers of under‑five children in the rural study area belong to the poorest socio‑economic classes and they spend less on anti‑malarial treatment. Majority of the free ITN’s beneficiaries in both urban and rural study areas have used and benefitted from them

Key words: BIA, ITNs, nigeria, pregnancy