Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review

Dina Barffo; Roland Kuuzagr Nuotol; Raouf Alebshehy; Nura Musa Shuaib; Jato Denis Mbako

doi:doi:10.11648/j.cajph.20210701.11

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Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review

Dina Barffo, Roland Kuuzagr Nuotol, Raouf Alebshehy, Nura Musa Shuaib, Jato Denis Mbako

Published in Central African Journal of Public Health (Volume 7, Issue 1)

Received: 9 October 2020 Accepted: 19 December 2020 Published: 12 January 2021

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Abstract

Malaria continues to be a public health challenge in Ghana, especially among children under five years. World Health Organization recommends 80% usage of insecticide treated nets as it is one of the most effectiveness means of preventing malaria. However, usage of insecticide treated nets is only 47% among this vulnerable group in Ghana, which is below the recommended rate. This in-depth review aims to explore factors contributing to low net utilization among under-fives in Ghana and analyze interventions that have improved utilization in countries of similar context and discuss their applicability in Ghana. This review was based on secondary data. Using a conceptual framework, factors leading to low net usage among under-fives and interventions that have proved to increase usage in other countries were obtained from databases such as Global Health, Medline, PubMed and Web of Science and websites of organisations such as Ministry of Health, Ghana Health Service, Ministry of Education and World Health Organization. A feasibility assessment tool was applied in analysing each intervention identified and appraised based on their feasibility in Ghana. Increasing age of a child, lack of mechanisms for monitoring net usage at home, large family size, negative perception and attitude towards its usage and lack of education on its correct usage emerged as factors contributing to low net usage among children under five in Ghana. Having analysed these factors, in addition to feasible interventions in addressing low usage, malaria stakeholders in Ghana need to evaluate these interventions to assess how appropriate and applicable they are in Ghana to increase net usage among under-fives.

Published in	Central African Journal of Public Health (Volume 7, Issue 1)
DOI	10.11648/j.cajph.20210701.11
Page(s)	1-10
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Malaria, Under-fives, Insecticide Treated Net, Utilization

References

[1]	Organisation, W. H. World Health Organisation: Malaria. 2016a [cited 2016 21 July]; Available from: http://www.who.int/.
[2]	Sumbele, I. U. N., M. Samje, and T. Nkuo-Akenji, A longitudinal study on anaemia in children with Plasmodium falciparuminfection in the Mount Cameroon region: prevalence, risk factors and perceptions by caregivers. BMC infectious diseases, 2013. 13 (1): p. 123.
[3]	Nankabirwa, J., et al., Malaria in school-age children in A frica: an increasingly important challenge. Tropical Medicine International Health, 2014. 19 (11): p. 1294-1309.
[4]	Asenso-Okyere, K., et al., A review of the economic impact of malaria in agricultural development. Agricultural economics, 2011. 42 (3): p. 293-304.
[5]	Health, M. O. Anti-Malaria Drug Policy for Ghana. 2009 [cited 2016 22 February]; Available from: http://apps.who.int.
[6]	Fund, U. N. I. C. s. E. United Nations International Children's Emergency Fund. Malaria. 2013 [cited 2016 20 February]; Available from: http://www.unicef.org/.
[7]	Yang, G.-g., et al., A meta-regression analysis of the effectiveness of mosquito nets for malaria control: The value of long-lasting insecticide nets. International journal of environmental research public health, 2018. 15 (3): p. 546.
[8]	Organisation, W. H. Global technical strategy and targets for malaria 2016–2030. 2015a [cited 2016 21 July]; Available from: http://apps.who.int.
[9]	Organisation, W. H. World Malaria Report. 2015b [cited 2016 21 July]; Available from: http://apps.who.int/iris/bitstream/10665/200018/1/9789241565158_eng.
[10]	Abdul-Aziz, A., E. Harris, and L. Munyakazi, Risk factors in malaria mortality among children in Northern Ghana: a case study at the tamale teaching hospital. International Journal of Business Social Research, 2012. 2 (5).
[11]	Nonvignon, J., et al., Economic burden of malaria on businesses in Ghana: a case for private sector investment in malaria control. Malaria journal, 2016. 15 (1): p. 1-10.
[12]	Govella, N. J., F. O. Okumu, and G. F. Killeen, Insecticide-treated nets can reduce malaria transmission by mosquitoes which feed outdoors. The American journal of tropical medicine hygiene, 2010. 82 (3): p. 415-419.
[13]	Organisation, W. H. The Ecological Framework. 2016b [cited 2016 27 July]; Available from: http://www.who.int/violenceprevention/approach/ecology/en.
[14]	Service, G. H., Ghana Malaria Programme Review. 2013.
[15]	Yennuyar, B. I., The Supply and Demand Factors affecting the use of Insecticides treated Mosquito Nets in the Greater Accra Region. 2015, University of Ghana.
[16]	Service, G. H., National Malaria Control Programme. 2015.
[17]	de Savigny, D., et al., Introducing vouchers for malaria prevention in Ghana and Tanzania: context and adoption of innovation in health systems. Health policy planning, 2012. 27 (suppl_4): p. iv32-iv43.
[18]	Kolaczinski, K., School-Based Distribution of Long-Lasting Insecticidal Nets: A Short Guide Based on Recent Country Experience. 2014, Citeseer.
[19]	Smith Paintain, L., et al., Evaluation of a universal long-lasting insecticidal net (LLIN) distribution campaign in Ghana: cost effectiveness of distribution and hang-up activities. Malaria Journal, 2014. 13 (1): p. 71.
[20]	n.a. Roll Back Malaria. (2014). Malaria: Country Profiles. 2014 [cited 2016 28 July]; Available from: https://www.gov.uk.
[21]	n.a. Demographic Health Survey. Ghana. 2014 [cited 2016 01 February]; Available from: https://dhsprogram.com.
[22]	Kumar, S., et al., The social ecological model as a framework for determinants of 2009 H1N1 influenza vaccine uptake in the United States. Health Education Behavior, 2012. 39 (2): p. 229-243.
[23]	Prevention, C. f. D. C. a. Social Ecological Model. Assessed at. Retrieved on,.. 2013 [cited 2016 30 July]; Available from: http://www.cdc.gov.
[24]	Ruderman, M., An introduction to the ecological model in public health. Department of Population, Family Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 2013: p. 1-5.
[25]	Walley, J. and J. Wright, Public health: An action guide to improving health. 2010: Oxford University Press.
[26]	Moher, D., et al., Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS med, 2009. 6 (7): p. e1000097.
[27]	Greenaway, E. S., J. Leon, and D. P. Baker, Understanding the association between maternal education and use of health services in Ghana: exploring the role of health knowledge. Journal of biosocial science, 2012. 44 (6): p. 733.
[28]	Baume, C. A. and A. C. Franca-Koh, Predictors of mosquito net use in Ghana. Malaria journal, 2011. 10 (1): p. 265.
[29]	Al-Dubai, S. A., et al., Exploration of risk taking behaviors and perceived susceptibility of colorectal cancer among Malaysian adults: a community based cross-sectional study. BMC public health, 2013. 13 (1): p. 930.
[30]	Beer, N., et al., A qualitative study on caretakers' perceived need of bed-nets after reduced malaria transmission in Zanzibar, Tanzania. BMC public health, 2012. 12 (1): p. 606.
[31]	Koenker, H. M., et al., A good night’s sleep and the habit of net use: perceptions of risk and reasons for bed net use in Bukoba and Zanzibar. Malaria Journal, 2013. 12 (1): p. 1-12.
[32]	Kodom, A., Usage and effectiveness of mosquito treated bed net by pregnant women and children in preventing malaria in Shai-Osudoku district in Greater Accra region of Ghana. Peak Journal of Public Health and Management, 2014. 2 (2): p. 35-41.
[33]	Chase, C., et al., Determinants of household demand for bed nets in a rural area of southern Mozambique. Malaria Journal, 2009. 8 (1): p. 1-10.
[34]	UNICEF, Multiple Indicator Cluster Survey (2011). Monitoring the situation of children and women in Ghana. 2011.
[35]	Laar, A., A. K. Laar, and P. A. Dalinjong, Community perception of malaria and its influence on health-seeking behaviour in rural Ghana: a descriptive study. Malaria World Journal, 2013. 4 (1): p. 269-278.
[36]	Pell, C., et al., Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi. PloS one, 2013. 8 (1): p. e53747.
[37]	Nyavor, K. D., et al., Assessing the ownership, usage and knowledge of insecticide treated nets (ITNs) in malaria prevention in the hohoe municipality, Ghana. Pan African Medical Journal, 2017. 28 (1).
[38]	Nketiah-Amponsah, E., Mothers' demand for preventive healthcare for children aged under-five years: the case of utilization of insecticide-treated bednets in Ghana. Journal of sustainable development, 2010. 3 (2): p. 98.
[39]	Service, G. S., 2010 Population and Housing Census: Summary Report of Final Results. 2012.
[40]	Minakawa, N., et al., Sleeping on the floor decreases insecticide treated bed net use and increases risk of malaria in children under 5 years of age in Mbita District, Kenya. Parasitology, 2015. 142 (12): p. 1516-1522.
[41]	Bashinyora, J. B., Utilisation of insecticide treated nets in households with children under 5 years in muhorro sub county, kibaale district, uganda. 2010, Kampala: Makerere University.
[42]	Dizon-Ross, R., P. Dupas, and J. Robinson, Governance and the effectiveness of public health subsidies. 2015, National Bureau of Economic Research.
[43]	Bowen, H. L., Impact of a mass media campaign on bed net use in Cameroon. Malaria journal, 2013. 12 (1): p. 36.
[44]	Keefer, P. and S. Khemani, Mass media and public education: The effects of access to community radio in Benin. Journal of Development Economics, 2014. 109: p. 57-72.
[45]	Kilian, A., et al., The effect of single or repeated home visits on the hanging and use of insecticide-treated mosquito nets following a mass distribution campaign-a cluster randomized, controlled trial. PLoS One, 2015. 10 (3): p. e0119078.
[46]	Gakpey, K., et al., Strategies towards attainment of universal coverage of long lasting insecticide treated nets (LLINs) distribution: experiences and lessons from Ghana. Parasites vectors, 2016. 9 (1): p. 35.
[47]	Service, G. H., Ghana Health Service. Annual Report. 2010.
[48]	Darko, S. Eight surprising consequences of Ghana’s power outages. 2015.
[49]	Reference, P. Monitoring the situation of children and women in Ghana 2016 [cited 2016 28 July]; Available from: http://www.pressreference.com.
[50]	Freeman, B., et al., Social media campaigns that make a difference: what can public health learn from the corporate sector and other social change marketers. Public Health Res Pract, 2015. 25 (2): p. e2521517.
[51]	Ayi, I., et al., School-based participatory health education for malaria control in Ghana: engaging children as health messengers. Malaria Journal, 2010. 9 (1): p. 98.
[52]	Roschnik, N. Malaria control in schools in Mali. 2010 [cited 2016 10 July]; Available from: http://www.savethechildren.org.
[53]	America, V. o. Traditional Beliefs Play Major Role in Ghanaian Health Care. 2010 [cited 2016 27 May]; Available from: http://www.voanews.com
[54]	Development, U. S. A. f. I. First Principles: Designing Effective Education Programs for School Health in Developing Countries. 2011 [cited 2016 3 August]; Available from: http://www.equip123.net.
[55]	Services, C. R. Child-led School Health Education Programs. 2009 [cited 2016 6 May]; Available from: http://www.crs.org.
[56]	Alison, B. C. and P. J. Paul J Krezanoski, Health Policy and Planning. 2017. 32 (2): p. 178–193.
[57]	Brooker, S., Malaria control in schools: a toolkit on effective education sector responses to malaria in Africa. 2009, The World Bank.
[58]	Nonaka, D., et al., Distribution of subsidized insecticide-treated bed nets through a community health committee in Boboye Health District, Niger. Tropical medicine health, 2012.
[59]	Bonner, K., et al., Design, implementation and evaluation of a national campaign to distribute nine million free LLINs to children under five years of age in Tanzania. Malaria Journal, 2011. 10 (1): p. 73.
[60]	Service, G. H., Ghana Health Service. Annual Report. 2011.
[61]	Service, G. H., Supplies, Stores and Drugs Management Division. 2014.
[62]	Desrochers, R. E., et al., Effectiveness of post-campaign, door-to-door, hang-up, and communication interventions to increase long-lasting, insecticidal bed net utilization in Togo (2011–2012): a cluster randomized, control trial. Malaria journal, 2014. 13 (1): p. 260.
[63]	Perry, H. B., R. Zulliger, and M. M. Rogers, Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness. Annual review of public health, 2014. 35: p. 399-421.
[64]	Keating, J., et al., A quasi-experimental evaluation of an interpersonal communication intervention to increase insecticide-treated net use among children in Zambia. Malaria journal, 2012. 11 (1): p. 313.
[65]	Rickard, D. G., et al., Closing the gap between insecticide treated net ownership and use for the prevention of malaria. Progress in community health partnerships: research, education, action, 2011. 5 (2): p. 123-131.

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Dina Barffo, Roland Kuuzagr Nuotol, Raouf Alebshehy, Nura Musa Shuaib, Jato Denis Mbako. (2021). Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review. Central African Journal of Public Health, 7(1), 1-10. https://doi.org/10.11648/j.cajph.20210701.11

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ACS Style

Dina Barffo; Roland Kuuzagr Nuotol; Raouf Alebshehy; Nura Musa Shuaib; Jato Denis Mbako. Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review. Cent. Afr. J. Public Health 2021, 7(1), 1-10. doi: 10.11648/j.cajph.20210701.11

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AMA Style

Dina Barffo, Roland Kuuzagr Nuotol, Raouf Alebshehy, Nura Musa Shuaib, Jato Denis Mbako. Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review. Cent Afr J Public Health. 2021;7(1):1-10. doi: 10.11648/j.cajph.20210701.11

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@article{10.11648/j.cajph.20210701.11,
  author = {Dina Barffo and Roland Kuuzagr Nuotol and Raouf Alebshehy and Nura Musa Shuaib and Jato Denis Mbako},
  title = {Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review},
  journal = {Central African Journal of Public Health},
  volume = {7},
  number = {1},
  pages = {1-10},
  doi = {10.11648/j.cajph.20210701.11},
  url = {https://doi.org/10.11648/j.cajph.20210701.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20210701.11},
  abstract = {Malaria continues to be a public health challenge in Ghana, especially among children under five years. World Health Organization recommends 80% usage of insecticide treated nets as it is one of the most effectiveness means of preventing malaria. However, usage of insecticide treated nets is only 47% among this vulnerable group in Ghana, which is below the recommended rate. This in-depth review aims to explore factors contributing to low net utilization among under-fives in Ghana and analyze interventions that have improved utilization in countries of similar context and discuss their applicability in Ghana. This review was based on secondary data. Using a conceptual framework, factors leading to low net usage among under-fives and interventions that have proved to increase usage in other countries were obtained from databases such as Global Health, Medline, PubMed and Web of Science and websites of organisations such as Ministry of Health, Ghana Health Service, Ministry of Education and World Health Organization. A feasibility assessment tool was applied in analysing each intervention identified and appraised based on their feasibility in Ghana. Increasing age of a child, lack of mechanisms for monitoring net usage at home, large family size, negative perception and attitude towards its usage and lack of education on its correct usage emerged as factors contributing to low net usage among children under five in Ghana. Having analysed these factors, in addition to feasible interventions in addressing low usage, malaria stakeholders in Ghana need to evaluate these interventions to assess how appropriate and applicable they are in Ghana to increase net usage among under-fives.},
 year = {2021}
}

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TY  - JOUR
T1  - Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review
AU  - Dina Barffo
AU  - Roland Kuuzagr Nuotol
AU  - Raouf Alebshehy
AU  - Nura Musa Shuaib
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PY  - 2021
N1  - https://doi.org/10.11648/j.cajph.20210701.11
DO  - 10.11648/j.cajph.20210701.11
T2  - Central African Journal of Public Health
JF  - Central African Journal of Public Health
JO  - Central African Journal of Public Health
SP  - 1
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PB  - Science Publishing Group
SN  - 2575-5781
UR  - https://doi.org/10.11648/j.cajph.20210701.11
AB  - Malaria continues to be a public health challenge in Ghana, especially among children under five years. World Health Organization recommends 80% usage of insecticide treated nets as it is one of the most effectiveness means of preventing malaria. However, usage of insecticide treated nets is only 47% among this vulnerable group in Ghana, which is below the recommended rate. This in-depth review aims to explore factors contributing to low net utilization among under-fives in Ghana and analyze interventions that have improved utilization in countries of similar context and discuss their applicability in Ghana. This review was based on secondary data. Using a conceptual framework, factors leading to low net usage among under-fives and interventions that have proved to increase usage in other countries were obtained from databases such as Global Health, Medline, PubMed and Web of Science and websites of organisations such as Ministry of Health, Ghana Health Service, Ministry of Education and World Health Organization. A feasibility assessment tool was applied in analysing each intervention identified and appraised based on their feasibility in Ghana. Increasing age of a child, lack of mechanisms for monitoring net usage at home, large family size, negative perception and attitude towards its usage and lack of education on its correct usage emerged as factors contributing to low net usage among children under five in Ghana. Having analysed these factors, in addition to feasible interventions in addressing low usage, malaria stakeholders in Ghana need to evaluate these interventions to assess how appropriate and applicable they are in Ghana to increase net usage among under-fives.
VL  - 7
IS  - 1
ER  -

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Author Information

Dina Barffo

Department of Community Medicine, National Health Service, Epsom, United Kingdom
Roland Kuuzagr Nuotol

Department of Community Health, Kintampo College of Health, Kintampo, Ghana
Raouf Alebshehy

Department of Health, University of Bath, Bath, United Kingdom
Nura Musa Shuaib

Department of Public Health, Ministry of Health, Dutse, Nigeria
Jato Denis Mbako

Department of Health Care, Integrated Health for All Foundation, Yaounde, Cameroon

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Dina Barffo, Roland Kuuzagr Nuotol, Raouf Alebshehy, Nura Musa Shuaib, Jato Denis Mbako. (2021). Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review. Central African Journal of Public Health, 7(1), 1-10. https://doi.org/10.11648/j.cajph.20210701.11

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ACS Style

Dina Barffo; Roland Kuuzagr Nuotol; Raouf Alebshehy; Nura Musa Shuaib; Jato Denis Mbako. Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review. Cent. Afr. J. Public Health 2021, 7(1), 1-10. doi: 10.11648/j.cajph.20210701.11

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AMA Style

Dina Barffo, Roland Kuuzagr Nuotol, Raouf Alebshehy, Nura Musa Shuaib, Jato Denis Mbako. Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review. Cent Afr J Public Health. 2021;7(1):1-10. doi: 10.11648/j.cajph.20210701.11

Copy | Download

@article{10.11648/j.cajph.20210701.11,
  author = {Dina Barffo and Roland Kuuzagr Nuotol and Raouf Alebshehy and Nura Musa Shuaib and Jato Denis Mbako},
  title = {Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review},
  journal = {Central African Journal of Public Health},
  volume = {7},
  number = {1},
  pages = {1-10},
  doi = {10.11648/j.cajph.20210701.11},
  url = {https://doi.org/10.11648/j.cajph.20210701.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20210701.11},
  abstract = {Malaria continues to be a public health challenge in Ghana, especially among children under five years. World Health Organization recommends 80% usage of insecticide treated nets as it is one of the most effectiveness means of preventing malaria. However, usage of insecticide treated nets is only 47% among this vulnerable group in Ghana, which is below the recommended rate. This in-depth review aims to explore factors contributing to low net utilization among under-fives in Ghana and analyze interventions that have improved utilization in countries of similar context and discuss their applicability in Ghana. This review was based on secondary data. Using a conceptual framework, factors leading to low net usage among under-fives and interventions that have proved to increase usage in other countries were obtained from databases such as Global Health, Medline, PubMed and Web of Science and websites of organisations such as Ministry of Health, Ghana Health Service, Ministry of Education and World Health Organization. A feasibility assessment tool was applied in analysing each intervention identified and appraised based on their feasibility in Ghana. Increasing age of a child, lack of mechanisms for monitoring net usage at home, large family size, negative perception and attitude towards its usage and lack of education on its correct usage emerged as factors contributing to low net usage among children under five in Ghana. Having analysed these factors, in addition to feasible interventions in addressing low usage, malaria stakeholders in Ghana need to evaluate these interventions to assess how appropriate and applicable they are in Ghana to increase net usage among under-fives.},
 year = {2021}
}

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TY  - JOUR
T1  - Review of Determinants of Low Insecticide Treated Net Utilization and Interventions to Improve Utilization Among Under-Fives in Ghana: An In-depth Review
AU  - Dina Barffo
AU  - Roland Kuuzagr Nuotol
AU  - Raouf Alebshehy
AU  - Nura Musa Shuaib
AU  - Jato Denis Mbako
Y1  - 2021/01/12
PY  - 2021
N1  - https://doi.org/10.11648/j.cajph.20210701.11
DO  - 10.11648/j.cajph.20210701.11
T2  - Central African Journal of Public Health
JF  - Central African Journal of Public Health
JO  - Central African Journal of Public Health
SP  - 1
EP  - 10
PB  - Science Publishing Group
SN  - 2575-5781
UR  - https://doi.org/10.11648/j.cajph.20210701.11
AB  - Malaria continues to be a public health challenge in Ghana, especially among children under five years. World Health Organization recommends 80% usage of insecticide treated nets as it is one of the most effectiveness means of preventing malaria. However, usage of insecticide treated nets is only 47% among this vulnerable group in Ghana, which is below the recommended rate. This in-depth review aims to explore factors contributing to low net utilization among under-fives in Ghana and analyze interventions that have improved utilization in countries of similar context and discuss their applicability in Ghana. This review was based on secondary data. Using a conceptual framework, factors leading to low net usage among under-fives and interventions that have proved to increase usage in other countries were obtained from databases such as Global Health, Medline, PubMed and Web of Science and websites of organisations such as Ministry of Health, Ghana Health Service, Ministry of Education and World Health Organization. A feasibility assessment tool was applied in analysing each intervention identified and appraised based on their feasibility in Ghana. Increasing age of a child, lack of mechanisms for monitoring net usage at home, large family size, negative perception and attitude towards its usage and lack of education on its correct usage emerged as factors contributing to low net usage among children under five in Ghana. Having analysed these factors, in addition to feasible interventions in addressing low usage, malaria stakeholders in Ghana need to evaluate these interventions to assess how appropriate and applicable they are in Ghana to increase net usage among under-fives.
VL  - 7
IS  - 1
ER  -

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