Bed Net Use and Associated Factors in a Rice Farming Community in Central Kenya
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Background: Use of insecticide-treated nets (ITNs) continues to offer potential strategy for malaria prevention in endemic areas. However their effectiveness, sustainability and massive scale up remain a factor of socio-economic and cultural variables of the local community which are indispensable during design and implementation stages. Methods: An ethnographic household survey was conducted in four study villages which were purposefully selected to represent socio-economic and geographical diversity. In total, 400 households were randomly selected from the four study villages. Quantitative and qualitative information of the respondents were collected by use of semi-structured questionnaires and focus group discussions. Results: Malaria was reported the most frequently occurring disease in the area (93%) and its aetiology was attributed to other non-biomedical causes like stagnant water (16%), and long rains (13%). Factors which significantly caused variation in bed net use were occupant relationship to household head (χ2 = 105.705; df 14; P = 0.000), Age (χ2 = 74.483; df 14; P = 0.000), village (χ2 = 150.325; df 6; P = 0.000), occupation (χ2 = 7.955; df 3; P = 0.047), gender (χ2 = 4.254; df 1; P = 0.039) and education levels of the household head or spouse (χ2 = 33.622; df 6; P = 0.000). The same variables determined access and conditions of bed nets at household level. Protection against mosquito bite (95%) was the main reason cited for using bed nets in most households while protection against malaria came second (54%). Colour, shape and affordability were some of the key potential factors which determined choice, use and acceptance of bed nets in the study area. Conclusion: The study highlights potential social and economic variables important for effective and sustainable implementation of bed nets-related programmes in Sub-Saharan Africa.