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Mass Media Exposure and Its Impact on Malaria Prevention Behaviour Among Adult Women in Sub- Saharan Africa : Results from Malaria Indicator Surveys

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Mass Media Exposure and Its Impact on Malaria Prevention Behaviour Among Adult Women in Sub- Saharan Africa : Results from Malaria Indicator Surveys View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Warwick Research Archives Portal Repository Original citation: Yaya, Sanni, Uthman, Olalekan A., Amouzou, Agbessi and Bishwajit, Ghose (2018) Mass media exposure and its impact on malaria prevention behaviour among adult women in sub- Saharan Africa : results from malaria indicator surveys. Global Health Research and Policy, 3 (1). 20. doi:10.1186/s41256-018-0075-x Permanent WRAP URL: http://wrap.warwick.ac.uk/104399 Copyright and reuse: The Warwick Research Archive Portal (WRAP) makes this work of researchers of the University of Warwick available open access under the following conditions. This article is made available under the Creative Commons Attribution 4.0 International license (CC BY 4.0) and may be reused according to the conditions of the license. For more details see: http://creativecommons.org/licenses/by/4.0/ A note on versions: The version presented in WRAP is the published version, or, version of record, and may be cited as it appears here. For more information, please contact the WRAP Team at: [email protected] warwick.ac.uk/lib-publications Yaya et al. Global Health Research and Policy (2018) 3:20 Global Health https://doi.org/10.1186/s41256-018-0075-x Research and Policy RESEARCH Open Access Mass media exposure and its impact on malaria prevention behaviour among adult women in sub-Saharan Africa: results from malaria indicator surveys Sanni Yaya1* , Olalekan A. Uthman2, Agbessi Amouzou3 and Ghose Bishwajit1 Abstract Background: Mass media exposure plays a pivotal role in health communication and adoption of a healthy lifestyle. In this study, we aimed to measure the prevalence of malaria prevention behaviour among adultwomenineightmalaria- endemic countries in sub-Saharan Africa (SSA), and assess the influence of mass media exposure in the adoption of those behaviours. Methods: For this study, we collected cross-sectional data on 46,822 women aged between 15 and 49 years from the Malaria Indicator Surveys (MIS) conducted in Burkina Faso, Ghana, Mali, Malawi, Kenya, Nigeria, Sierra Leone and Uganda. As the outcome variable, malaria prevention behaviour was proxied by the use of insecticide treated nets (ITNs) and uptake of antimalarial drugs in last pregnancy. Results: The overall prevalence of sleeping under ITN and that of taking antimalarialdrugduringthelastpregnancywas respectively 67.9% (95%CI = 66.6–69.2) and 72.8% (95%CI = 71.3–74.2). However, there were disparities in the prevalence of using ITN and antimalarial drug use across the study countries. In the multivariable regression analysis, not receiving malaria related information from radio, poster/billboards, community events, and health workers were found to be significantly associated with reduction in the odds of using ITN the previous night. For the use of antimalarial drugs during last pregnancy, the odds were 23% [OR = 0.773, 95%CI = 0.625–0.956] lower for those who did not receive malaria information on radiocomparedwiththosewhoreceived. Conclusions: Thesefindingsindicateapotentiallyimportantrole of malaria information received through mass media on utilisation of ITN among women in SSA. More research is needed to explore the factors that limit the accessibility to malaria information through mass media. Keywords: Malaria prevention behaviour, Insecticide treated nets, Antimalarial drugs, Global health, Sub-Saharan Africa Background in the pattern of malaria; while the global malaria preva- In Africa, malaria costs approximately $12 billion in terms lence indicates that increasing number of countries in Asia of loss of Gross Domestic Product (GDP) each year, and and South America are being able to approach elimination has slowed the pace of economic growth by 1.3% per year [3], countries in sub-Saharan Africa on the other hand still as a result of lost lives and low productivity [1]. In 2012, an remain the most endemic region accounting for about 90% estimated 207 million people suffered from this preventable of the global malaria-related deaths [4]. and treatable disease, with about half of the global popula- Malaria burden is most entrenched among the poorest tion still at risk of transmission [2]. There is large disparity communities who often lack adequate knowledge about the causes, consequences and capacity to afford treatment and adopt preventive measures [5, 6]. Added to the affordability * Correspondence: [email protected] 1School of International Development and Global Studies, University of and behavioural issues, are the demographic and gender di- Ottawa, 120, University Private, Ottawa, ON K1N 6N5, Canada mensions which are usually less frequently talked about [6]. Full list of author information is available at the end of the article © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Yaya et al. Global Health Research and Policy (2018) 3:20 Page 2 of 9 There is compelling evidence regarding the fact that chil- tools [5, 6, 21]. However, the evidences are sporadic for dren and women are more vulnerable to malaria-related African countries and not much is known about the in- morbidity and mortality [6–8] with pregnant women about fluence of mass media on malaria prevention behaviour twice more likely to be at risk of transmission [9]. Besides such as the uptake of antimalarial drug use in pregnancy the direct consequences, malaria during pregnancy (gesta- and the use of ITNs. In the light of the above, we con- tional malaria) is also an important contributor to maternal ducted this study using data collected in Burkina Faso, anaemia which is associated with higher risk of pregnancy Ghana, Mali, Malawi, Kenya, Nigeria, Sierra Leone and complications and adverse birth outcomes [10–12]. Given Uganda between 2014 and 2016, to investigate the im- the long-term consequences of gestational malaria on ma- pact of exposures to mass media on malaria prevention ternal and child health, the World Health Organization rec- among women. ommends several preventive tools including the use of insecticide treated nets (ITNs) and provision of antimalarial Methods drugs (e.g. sulfadoxine-pyrimethamine intermittent pre- Settings and data source ventive treatment (SP-IPTp)) during prenatal health Data were obtained from the MIS conducted in Bur- check-ups [10]. According to a systematic review, using kina Faso (2014), Ghana (2016), Mali (2015), Malawi ITNs is an important mode of prevention that has benefi- (2014), Kenya (2015), Nigeria (2015), Sierra Leone cial effects against parasite prevalence in all gravidities in (2016), Uganda (2014–15). The surveys were con- the endemic regions of Africa [13]. Recommended uptake ducted with technical assistance from the National of SP-IPTp has also shown to improve maternal haemoglo- Bureau of Statistics (NBS) of each country. It was bin count and decrease the prevalence of placental malaria funded by ICF International through the Demographic infection at delivery and low birth weight [14–16]. and Health Survey (DHS) Program which is also a Despite the demonstrated benefits of these preventive USAID supported project in the implementation of measures, the use of antimalarial drugs and ITNs remains population and health surveys [24]. The countries far lower than optimum [14, 17, 18]. While the national were selected based on geographical diversity. The and international alliances are developing strategies to in- SSA countries included in this study were thus; East- crease the affordable provision of these services among ern (Kenya, Malawi and Uganda) and Western (Burki- womeninAfrica[1], the efficacy and success of these ef- na-Faso, Ghana, Mali, Nigeria and Sierra Leone) forts will ultimately depend on their adequate utilisation countries respectively (Fig. 1)[25]. which is largely reliant on women’sawarenessofthechal- The MIS s employed a stratified two-stage cluster design. lenges and knowledge of prevention. The healthcare system In the first stage, sampling strata were created from which also has a vital role to play in reducing the persistently high clusters were selected by a probability-proportional-to-size rates of malaria and associated morbidities in SSA and to technique. A complete listing in the selected clusters served promote effective health communication, health literacy as the sampling frame for the second stage. In the second and treatment-seeking-behaviour among the population stage, households were selected from each cluster by equal [19, 20]. Lack of knowledge and awareness regarding a dis- probability systematic sampling. Study participants were ease is a major drawback to prevention and intervention of women aged 15–49 years residing in non-institutional any public health challenge; this can be addressed greatly places in urban and rural areas. Details of the survey pro- by strengthening health communication tools and dissem- cedure have been reported in the method section of a re- inating health information through the conventional and/or
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