Inequalities in the use of insecticide-treated nets by pregnant women in Ghana, 2011 and 2017

• Published in: Malaria Journal
• Main Authors: Eugene Budu, Joshua Okyere, Felix Mensah, Simon Agongo Azure, Abdul-Aziz Seidu, Edward Kwabena Ameyaw, Bright Opoku Ahinkorah
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2022
• Subjects: Insecticide-treated net; Pregnant women; Ghana; Multiple indicator cluster survey; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-022-04388-z; https://doaj.org/article/169009a9138d4742a25a0c5b9120bcd4

Abstract Background Pregnant women and children are the most vulnerable group of people usually affected by malaria. The use of insecticide-treated nets is one of the proven interventions for mitigating malaria and its associated deaths in endemic regions, including Ghana. Meanwhile, there is limited evidence on the extent of inequality in insecticide-treated nets use by pregnant women in Ghana. This study assessed the inequalities in insecticide-treated nets use by pregnant women in Ghana. Methods Data from the 2011 and 2017 versions of the Ghana Multiple Indicator Cluster Surveys were used. The 2019 updated World Health Organization (WHO) HEAT software (version 3.1) was used for all analyses. Four equity stratifiers were employed to disaggregate insecticide-treated nets use by pregnant women in Ghana. These are economic status, level of education, place of residence, and sub-national region. Four measures were used to compute inequality namely Difference (D), Population Attributable risk (PAR), Population Attributable Fraction (PAF) and Ratio (R). Results The analyses indicated a rise in pregnant women’s insecticide-treated nets use from 32.6% in 2011 to 49.7% in 2017. Except sub-national region, all the factors showed mild inequality in insecticide-treated nets use. For instance, with respect to the economic status of pregnant women, only a slight inequality was exhibited by one of the simple measures in both 2011 (R = 0.3; 95% UI = 0.2–0.6) and 2017 (R = 0.5; 95% UI = 0.3–0.7). Marginal inequality in insecticide-treated nets use was noted in 2011 (R = 0.6; 95% UI = 0.5–0.9) and 2017 (R = 0.8; 95% UI = 0.6–0.9) for level of education. In the same vein, slight inequality was realized with respect to place of residence in 2011 (R = 0.4; 95% UI = 0.3–0.6) and 2017 (R = 0.6; 95% UI = 0.5–0.7). For sub-national region, both simple (D = 50.5; 95% UI = 30.7–70.4) and complex (PAF = 91.3; 95% UI = 72.3–110.3) measures demonstrated substantial inequality in 2011. In the case of 2017, considerable inequality in ...