The impact of behaviour change communication on the use of insecticide treated nets: a secondary analysis of ten post-campaign surveys ... View Full Text


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Article Info

DATE

2016-12

AUTHORS

Albert Kilian, Harriet Lawford, Chinazo N. Ujuju, Tarekegn A. Abeku, Ernest Nwokolo, Festus Okoh, Ebenezer Baba

ABSTRACT

BACKGROUND: Mass distribution campaigns of insecticide-treated nets for malaria prevention are usually accompanied by intensive behaviour change communication (BCC) to encourage hanging and use of nets. However, data on the effectiveness of these communication efforts are scarce. In preparation for the next round of mass campaigns in Nigeria, a secondary analysis of existing data from post-campaign surveys was undertaken to investigate the influence of BCC on net hanging and use. METHODS: Surveys were undertaken between 2009 and 2012 in ten states in Nigeria using standardized questionnaires. Two-stage cluster sampling was used to select households in each study site. Outcomes were defined as the effects of BCC message exposure and recall on knowledge, attitudes, perception as well as intentions and actual use. From the univariable analysis, potential confounders and explanatory variables were identified and key effects explored in multivariable linear or logistic regression models; terms in the models were kept if they had a marginal significance with p < 0.2. To quantify the effects from BCC, a treatment effect model was used with an inverse-probability weight regression adjustment. RESULTS: More than half of the respondents (58.4 %; 95 % CI 56.0, 60.7) had heard a message about net use or hanging during or after the distribution campaign, with media cited as the most common source of information. Attitude towards net use was positively linked to the number of messages recalled and was overall better in the northern study sites. The number of messages recalled was also the strongest predictor of knowledge (p < 0.001). All BCC outcomes showed a significant increase in net use, which was strongest for the confidence to take action regarding nets with an overall effect of 17 %-point increase of net use comparing poor and excellent confidence levels. Intention to use every night increased net use by 15 %-points and discussing net use in the family by 8 % points. All these effects were statistically significant (p < 0.001). CONCLUSIONS: Multichannel BCC campaigns as well as other media were effective in contributing to an increase in net culture, hanging and use, particularly by vulnerable groups. More... »

PAGES

422

References to SciGraph publications

  • 2014-12. Comparing two approaches for estimating the causal effect of behaviour-change communication messages promoting insecticide-treated bed nets: an analysis of the 2010 Zambia malaria indicator survey in MALARIA JOURNAL
  • 2012-12. Ownership and usage of mosquito nets after four years of large-scale free distribution in Papua New Guinea in MALARIA JOURNAL
  • 2013-12. Evaluation of the 2011 long-lasting, insecticide-treated net distribution for universal coverage in Togo in MALARIA JOURNAL
  • 2013-12. Universal coverage with insecticide-treated nets – applying the revised indicators for ownership and use to the Nigeria 2010 malaria indicator survey data in MALARIA JOURNAL
  • 2010-12. Assessing bed net use and non-use after long-lasting insecticidal net distribution: a simple framework to guide programmatic strategies in MALARIA JOURNAL
  • 2012-12. A quasi-experimental evaluation of an interpersonal communication intervention to increase insecticide-treated net use among children in Zambia in MALARIA JOURNAL
  • 2009-12. Factors associated with use and non-use of mosquito nets owned in Oromia and Amhara Regional States, Ethiopia in MALARIA JOURNAL
  • 2011-12. Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya in FILARIA JOURNAL
  • 2011-12. Reported reasons for not using a mosquito net when one is available: a review of the published literature in MALARIA JOURNAL
  • 2012-12. Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria in MALARIA JOURNAL
  • 2012-12. Estimates of child deaths prevented from malaria prevention scale-up in Africa 2001-2010 in MALARIA JOURNAL
  • 2013-12. Gender differences in the use of insecticide-treated nets after a universal free distribution campaign in Kano State, Nigeria: post-campaign survey results in MALARIA JOURNAL
  • 2013-12. Impact of a mass media campaign on bed net use in Cameroon in MALARIA JOURNAL
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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27542940


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    45 schema:description BACKGROUND: Mass distribution campaigns of insecticide-treated nets for malaria prevention are usually accompanied by intensive behaviour change communication (BCC) to encourage hanging and use of nets. However, data on the effectiveness of these communication efforts are scarce. In preparation for the next round of mass campaigns in Nigeria, a secondary analysis of existing data from post-campaign surveys was undertaken to investigate the influence of BCC on net hanging and use. METHODS: Surveys were undertaken between 2009 and 2012 in ten states in Nigeria using standardized questionnaires. Two-stage cluster sampling was used to select households in each study site. Outcomes were defined as the effects of BCC message exposure and recall on knowledge, attitudes, perception as well as intentions and actual use. From the univariable analysis, potential confounders and explanatory variables were identified and key effects explored in multivariable linear or logistic regression models; terms in the models were kept if they had a marginal significance with p < 0.2. To quantify the effects from BCC, a treatment effect model was used with an inverse-probability weight regression adjustment. RESULTS: More than half of the respondents (58.4 %; 95 % CI 56.0, 60.7) had heard a message about net use or hanging during or after the distribution campaign, with media cited as the most common source of information. Attitude towards net use was positively linked to the number of messages recalled and was overall better in the northern study sites. The number of messages recalled was also the strongest predictor of knowledge (p < 0.001). All BCC outcomes showed a significant increase in net use, which was strongest for the confidence to take action regarding nets with an overall effect of 17 %-point increase of net use comparing poor and excellent confidence levels. Intention to use every night increased net use by 15 %-points and discussing net use in the family by 8 % points. All these effects were statistically significant (p < 0.001). CONCLUSIONS: Multichannel BCC campaigns as well as other media were effective in contributing to an increase in net culture, hanging and use, particularly by vulnerable groups.
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