Outcome Objective Oriented Evaluation on Insecticide Treated Net Distribution and Utilization in Agaro Town, Jimma Zone, Southwest Ethiopia

Abstract

BACKGROUND: Insecticide-treated nets (ITNs) are regarded as one of the most effective strategies to prevent malaria in Africa. ITNs in an area of intense malaria transmission may be to reduce the overall mosquito population in addition to reducing human-vector contact at the individual level .Widespread use of insecticide-treated nets and other appropriate methods helps to limit human-mosquito contact. OBJECTIVE: The aims of this study is to assess utilization of ITNs by HHs , under five children, and pregnant women, the level of knowledge of the community about malaria cause, transmission, prevention and ITNs use and usage, the status of ITNs and the factors affecting its use among freely supplied households in Agaro town. METHODS: The design of the evaluation was community based cross-sectional survey. The techniques used were survey, document review, expert interview and focus group discussions by employing semi-structured questionnaires and observational check-list in the survey, semi-structured interview guide for expert interview, and focus group discussion guideline and document review guide for FGDs and document review. The tools prepared for the survey were pre-tested questionnaires, the sample units were selected by simple random sampling technique and the sample size in each kebeles was assigned according to their population proportion to size. The sampling technique for all qualitative data was purposive. Data collectors were five nurses and two supervisors (one sanitarian and one health officer) training for three days for data collectors and one day for supervisors was given and pre- test was done at Jimma town. The study period was January 10-24, 2011. RESULT: The total study participants were 424 households of which 411(97.0%) were females and 13(3.0%) were males of the headship of the respondants 386(91.0%) were males and 38(9.0%) was females. Regarding the ownership of the house 331(78.0%) were government houses and 93(22.0%) were private houses. The majority 251(59.0%) of respondants were Oromo, 299(70.0%) were muslin, 381(90.0%) were married, Xi332(78.0%) were literate, 316(75.0%) were housewife, and the mean age is 40.14 and the mean family size is 4.74. Concerning the knowledge 400(94.0%) accept malaria is their problem, 345(81.0%) mentioned mosquito bite is the main cause for malaria transmission, 387(91.0%) agreed mosquito net can prevent malaria, 96.0% believes malaria can be prevented, 418(99.0%) have heard about mosquito net. Regarding mosquito net possession 269(63.4%) households possess any mosquito net the mean mosquito net per household is 0.92 from the total respondent and 1.47 per households from those households who possess mosquito net. From the 269 households who possess any net 241(90.0%) households possess program ITNs. From the total study participants a total of 389 ITNs was found of which 346(89%) were intact, 293(75.3%) were mounted and according to this study utilization measurement it is found 83.68%. CONCLUSION: The ITNs program was measured by the evaluation dimensions and these dimensions was measured separately and found as follows the availability dimension 76.1% judged as very good implementation, accessibility dimension 100% judged as excellent implementation, and acceptability dimension 75.0% judged as very good implementation totally the implementation of Agaro ITNs program is found 83.9% which is judged as very good implementation level. Even though the implementation level is very good gaps were identified and most of the gaps are observed in the availability and acceptability dimensions. In the availability dimension the problems observed are shortage of mosquito net, knowledge gap, ITNs distribution, follow-up (home visit for checking the proper utilization of ITN by HHs), coordination, recording and documentation, lack of on time and enough distribution mosquito nets. In the acceptability dimension the problems observed are information gap, lack of proper and regular awareness creation, and leakage of ITNs. The result of this study calls to do more on intensive ITNs availability, continuous follow up (check-up) for ITNs proper utilization, and targeted and continuous awareness creation activity to be done.