UGANDA 2018-19 UGANDA UGANDA Malaria Indicator Survey Malaria Indicator Survey 2018-19 GOVERNMENT OF UGANDA Uganda Malaria Indicator Survey 2018-19 Ministry of Health National Malaria Control Division Kampala, Uganda Uganda Bureau of Statistics Kampala, Uganda The DHS Program ICF Rockville, Maryland, USA March 2020 The 2018-19 Uganda Malaria Indicator Survey (2018-19 UMIS) was implemented by the National Malaria Control Division (NMCD) and the Uganda Bureau of Statistics (UBOS). Financial support for the survey was provided by the United States Agency for International Development (USAID) through the President’s Malaria Initiative (PMI), by the United Kingdom Department for International Development (DFID), by the World Health Organization (WHO), and by the Government of Uganda with Global Fund support. ICF provided technical assistance through The DHS Program, a USAID-funded project offering support and technical assistance in the implementation of population and health surveys in countries worldwide. Additional information about the 2018-19 UMIS may be obtained from the National Malaria Control Division, Plot 6, Lourdes Rd., Wandegeya, P.O. Box 7272, Kampala, Uganda. Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; telephone: +1-301-407-6500; fax: +1-301-407-6501; email: [email protected]; internet: www.DHSprogram.com. Recommended citation: Uganda National Malaria Control Division (NMCD), Uganda Bureau of Statistics (UBOS), and ICF. 2020. Uganda Malaria Indicator Survey 2018-19. Kampala, Uganda, and Rockville, Maryland, USA: NMCD, UBOS, and ICF. CONTENTS TABLES AND FIGURES ............................................................................................................................ v FOREWORD ............................................................................................................................................... ix ACKNOWLEDGEMENT ........................................................................................................................... xi ABBREVIATIONS AND ACRONYMS ................................................................................................. xiii READING AND UNDERSTANDING TABLES FROM THE 2018-19 UGANDA MALARIA INDICATOR SURVEY (UMIS) .................................................................................................. xv MAPS OF UGANDA .............................................................................................................................. xxiii 1 INTRODUCTION AND SURVEY METHODOLOGY .............................................................. 1 1.1 Survey Objectives ................................................................................................................ 1 1.2 Sample Design ..................................................................................................................... 1 1.3 Questionnaires ..................................................................................................................... 2 1.4 Anaemia and Malaria Testing .............................................................................................. 3 1.5 Training of Field Staff ......................................................................................................... 4 1.6 Fieldwork ............................................................................................................................. 5 1.7 Laboratory Testing .............................................................................................................. 5 1.8 Data Processing ................................................................................................................... 5 1.9 Ethical Consideration .......................................................................................................... 6 1.10 Community Mobilisation ..................................................................................................... 6 1.11 Response Rates .................................................................................................................... 6 2 CHARACTERISTICS OF HOUSEHOLDS AND WOMEN ...................................................... 7 2.1 Drinking Water Sources and Treatment .............................................................................. 7 2.2 Sanitation ............................................................................................................................. 8 2.3 Housing Characteristics ....................................................................................................... 8 2.4 Dwelling Characteristics ...................................................................................................... 9 2.5 Household Wealth ............................................................................................................... 9 2.6 Household Population and Composition ........................................................................... 10 2.7 Characteristics of Respondents .......................................................................................... 11 2.8 Educational Attainment of Women ................................................................................... 11 2.9 Literacy of Women ............................................................................................................ 12 3 MALARIA PREVENTION .......................................................................................................... 23 3.1 Ownership of Insecticide-Treated Nets ............................................................................. 24 3.2 Household Access and Use of ITNs .................................................................................. 26 3.3 Reasons Mosquito Nets Were Not Used ........................................................................... 28 3.4 Indoor Residual Spraying .................................................................................................. 28 3.5 Use of ITNs by Children and Pregnant Women ................................................................ 29 3.6 Malaria in Pregnancy ......................................................................................................... 31 4 MALARIA IN CHILDREN ......................................................................................................... 47 4.1 Care Seeking for Fever in Children ................................................................................... 47 4.2 Diagnostic Testing of Children with Fever ....................................................................... 48 4.3 Community Health Workers .............................................................................................. 49 4.4 Use of Recommended Antimalarials ................................................................................. 50 4.5 Prevalence of Low Haemoglobin in Children ................................................................... 50 4.6 Prevalence of Malaria in Children ..................................................................................... 52 Table of Contents • iii 5 MALARIA KNOWLEDGE, PRACTISE, EXPOSURE TO MESSAGES, AND BELIEFS .. 67 5.1 Knowledge of Causes of Malaria ...................................................................................... 67 5.2 Knowledge of Ways to Avoid Malaria .............................................................................. 68 5.3 Knowledge of Medicines Given to Avoid Getting Malaria During Pregnancy ................. 69 5.4 Ideal Timing of Treatment for Children With Fever ......................................................... 70 5.5 Malaria Knowledge and Behaviour ................................................................................... 70 5.6 Exposure to Malaria Messages .......................................................................................... 70 5.7 Opinions and Beliefs about Malaria .................................................................................. 72 REFERENCES ........................................................................................................................................... 81 Appendix A SAMPLE DESIGN .......................................................................................................... 83 A.1 Introduction ....................................................................................................................... 83 A.2 Sample Frame .................................................................................................................... 83 A.3 Sample Allocation and Sampling Procedures .................................................................... 85 A.4 Sample Probabilities and Sampling Weights ..................................................................... 86 Appendix B ESTIMATES OF SAMPLING ERRORS ..................................................................... 89 Appendix C DATA QUALITY TABLES ......................................................................................... 111 Appendix D PERSONS INVOLVED IN THE 2018-19 UGANDA MALARIA INDICATOR SURVEY ......................................................................................................................... 115 Appendix E QUESTIONNAIRES ..................................................................................................... 121 iv • Table of Contents TABLES AND FIGURES 1 INTRODUCTION AND SURVEY METHODOLOGY .............................................................