Sustaining The Use Of The Insecticide Treated Bed Nets In The Upper East Region Of Ghana: Factors Militating Against Continuous Usage.

ABSTRACT

The control of the spread of endemic malaria is incumbent on the prevention of many mortalities and morbidities that are associated with the disease in the Upper East Region of Ghana. The insecticide treated bed nets are the most reliable and cost effective tools to use in the prevention of malaria. This study explored the usage patterns and decision making processes, level of knowledge on the risk of the non-use of the Insecticide Treated Net (ITN), barriers to sustained usage and the factors that facilitate sustained use of the ITN.  This was a mixed method study that used the multi stage sampling technique. The study used data from three key informant interviews conducted on District Malaria Control Officers and a structured survey from three study Districts in the Upper East Region. The study identified nature of the weather, season of the year, temperature, relative humidity, education, access to the ITN, number of persons living in the household and the belief and understanding of the household head to influence patterns of behaviour. On risk awareness; formal education is related to the level of consistent use of the ITN. Major barriers to consistent use of the ITN include over complacency, the influence of male dominance, improper use of the ITN and technical factors like poor retreatment schedule and lack of understanding in hanging the net. To have a sustained usage of the ITN in the region, the need to have a community retreatment centre for reimpregnation of the net is inescapable and the use of behaviour change communication methods to influence behaviour towards sustainable use of the ITN is critical. This study recommends that: Mosquito bed net users must roll up the net when not in use, and carefully at night, tucking in the net partially and fully when in bed, obey washing instructions and follow strict re-impregnation schedule. Also they are to inspect ITN for holes, check for mosquitoes trapped inside the net and sleep away from the edge of the bed so as to ensure the net is durable and provide profit for a long time to beneficiaries.