Abstract

Insecticide- treated nets are the most powerful malaria control tool if used correctly. Yet up to date, utilization is still unacceptably low: only 3 percent of African children are currently sleeping under an ITN, and about 20 percent are sleeping under any kind of net. Worse still, malaria continues to be the leading cause of child mortality and morbidity. The aim of this study was to investigate the intra-household factors that affect the utilization of ITNs in households with children under five. The study specifically sought to identify the intra-household practices that affect the use of ITNs among the under five; examined the knowledge, attitudes, perceptions and beliefs of caregivers towards the usage of ITNs; and lastly analysed the affordability of ITNs by households with children under five years. This study was conducted in Emure Ekiti, which were randomly selected and used a cross sectional design. The study findings show that first; there were intra-household factors that affected utilization of ITNs in households with children under five. These factors that affected utilization include; type of household structure, number of people sleeping in the household, intra-household gender relations, sleeping arrangements, disruption of sleeping patterns due to visitors and cultural rituals and functions. These factors affect consistency in utilization of ITNs and proper deployment. Secondly, knowledge on ITNs was found to be low though general knowledge about mosquito nets was found to be high. Utilization was also affected by poor perceptions, beliefs and attitudes that discourage caregivers from using the ITNs. Thirdly, access to ITNs was very inadequate and unavailable within the study community. The majority of the people being peasants, there were insufficient incomes and therefore ITNs were not a priority given the level of poverty. This study concluded that financial inadequacies at the household level, poor perceptions of caregivers and intra-household dynamics impact negatively on effective utilization of ITNs among the under fives. I would therefore recommend that; public-private partnership be adapted to ensure availability of ITNs and insecticides in local shops and other outlets including arrangements at village level to re-treat the nets, the economic level of caregivers should be boosted to counteract the financial inadequacies, adoption of a behaviour change strategy to transform caregivers ‟ perceptions, beliefs and attitudes; and massive education of the community.

Keywords: Prevention; Assessment; Malaria; Insecticide; Under-five; Emure-ekiti