A survey for long-lasting insecticidal net coverage and use in Ethiopia

Abstract

Introduction: The 2015 Ethiopia Malaria Indicators Survey shows that 64% of households owned Long Lasting Insecticide Net (LLIN) in Ethiopia. During the period between 2014-2016, 59.5 million LLINs were distributed.
Objective: To assess the LLINs coverage, utilization and physical condition across the different regions of Ethiopia.
Materials and Methods: National survey on LLIN was carried out in 2017. Three domains of estimation were considered in order to make separate survey estimates. For sample size determination different assumptions were also considered. Sample weighting was applied for data analysis . Twenty households were selected from each enumeration area randomly from the census (fresh list of the households) for questionnaire and interview administrations.
Results: In the 2017 LLINs survey, a total of 5527 households were surveyed with a response rate of 96.3%. The mean age of the participants was 22.47 years (standard deviation [SD] +16.989). Of the 20,982 participants, there were nearly an equal proportion of males and females (50.5%, vs. 49.5%, respectively). The extrapolated national malaria area weighted result of this survey indicated that 3,746,752 (64.8%) of the households owned at least one long lasting insecticide net in Ethiopia. The proportions of households with at least one LLIN for two people and the proportion of population that sleep under net in the night before the survey were found to be 39.1% and 42.6%, respectively. Similarly, proportion of under five children and pregnant women who slept under LLINs in the previous night before the survey were 51.4% and 59.1%, respectively. Nationally, the proportion of LLINs retention in the household was 54.3% (N = 2,033,658). But only 1,947,727(33.7%) of the households can recall the key LLINs messages. Although the national LLINs coverage was 64.8%, there was significant difference in LLIN coverage among regional states (P-value < 0.001). There is a difference among urban and rural areas regarding receiving information about LLINs utilization (P-value < 0.001).

Conclusions: Although a progress has been made in addressing universal coverage of LLINs in the country (64.8%), still almost 35% of households did not have LLINs in malarious areas (<2000m elevation). So, the NMCP and stakeholders should work together to  achieve universal coverage in malarious areas of the country. None of the Regional States fulfilled the national as well as the global target of LLINs coverage. Although almost 81% of the LLINs were distributed through the health extension workers, only 33.7% of the household participants had knowledge on mosquito net utilization. Hence, there is a need to scale up the distribution of LLINs to meet the national targets and enhance community awareness about net utilization.