The study was designed to ascertain the extent and patterns of utilization of insecticide treated bed nets (ITNs) among ante-natal and nursing mothers in Udenu Local Government Area of Enugu State. The descriptive survey research design was employed, utilizing the cross-sectional method. The instrument for data collection was the researcher structures questionnaire. The population for the study comprised all ante-natal and nursing mothers in Udenu LGA of Enugu State attending ante-natal and post-natal clinics in the private and government health centers. A sample size of 528 subjects were selected for the study. The statistical package for social science batch system was used to analyze the data; while t-Test statistic was used in testing all the hypotheses at .05 level of significance. The major findings from the study revealed that: ante-natal and nursing mothers utilized ITNs during pregnancy and after birth to moderate extent. Ante-natal and nursing mothers utilized ITNs for protecting their young children against mosquito bites to a moderate extent. Ante-natal and nursing mothers of all age groups marital status, and various occupation utilized ITNs to a moderate extent. Except antenatal mothers with none formal education who utilized ITNs to a low extent, others antenatal and nursing mothers with other levels of education utilized ITNs to a moderate extent. Except nursing mother who utilized ITNs during the day to a low extent, other nursing and antenatal mothers utilized ITNs during other periods to a moderate extent. There was no significant difference in the utilization of ITNs among ante-natal and nursing mothers based on age, marital status and occupations. There was no significant difference in the utilization of ITNs among ante-natal and nursing mothers based on the level of education during pregnancy and after childbirth while there was significant difference in protection of their young children with ITN’s based on level of education. There was no significant difference in the utilization of ITNs among ante-natal and nursing mother based on the period of the year during pregnancy, after childbirth and protection of their young children. The researcher, among other views, made the following recommendations based on the finding and discussions from the results. That is. the antenatal and nursing mothers should be adequately educated on the consequences of malaria in pregnancy and children below five years of age so that they will understand the need for early adoption and correct use of ITNs.


Title Page
Table of Contents

CHAPTER ONE: Introduction
Background to the Study
Statement of the Problem
Purpose of the Study
Research Questions
Significance of the Study
Scope of the Study

CHAPTER TWO:  Review of Related Literature
Conceptual Framework
Origin and development of insecticide treated bednets (ITNs)
Extent, pattern and utilization of ITNs
National policy on ITNs use
Factors associated with ITNs utilization
Theoretical Framework
Various pattern theory (VPT)
Diffusion of Innovation theory (DIT)
Health Believe Model (HBN)
Review of Empirical Studies
Summary of Literature Review

CHAPTER THREE:            Methods
Research Design
Area of the Study
Population for the Study
Sample and Sampling Techniques
Instrument for Data Collection
Validity of the instrument
Reliability of the instrument
Method of Data Collection
Method of Data Analysis

Summary of Major Findings

CHAPTER FIVE: Summary, Conclusions and Recommendations
Suggestions for further Studies




Background to the Study
Malaria had accompanied human kind for as long as 5,000 years; the first written evidence of disease dating back to 2,700 B.C. in the Chinese medical classic Nei Chin (Claudia, Corneille, Manuela, Bocar and Olaf, 2006). They noted that, protection techniques against insects, have also been known for ages and were used long before the malaria transmission processes was discovered. They also emphasized that, among the oldest approaches to prevent mosquito biting, was the use of bed nets and curtains, which in the ancient Roman and Greek world simply meant the spreading of gauze and muslin curtains over places to protect insects. Besides, the ancient Persians were said to destroy insects by using a powder dried flower of a Dalmatain pyrethrum. Claudia, Corneille, Manuela, Bocar and Olaf (2006) asserted that in recent years, these two techniques have been combined into the powerful tool of insecticide impregnated bed nets or insecticide treated net (ITNs) and curtains. According to their report, ITNs have consistently been shown to be very effective and sustainable in reducing malaria morbidity and mortality in children of different malaria endemic areas.

Park (2007) indicated that insecticides are substances which are used to kill insects. Park further stated that the control of anthropoid borne diseases by insecticides is one of the greatest triumphs of public health during the 20th century. She further stated that insecticides have not only controlled malaria, plague, typhus and other diseases transmitted by insects, but also brought vast economic and social benefits through better health and increased food production. Sharp, Ngxongo, Bothn, Ridl and Le Sueur (1988) indicated that the first malaria control programmes in South Africa began in the 1920s with larval control. Anti-malaria committees were set up to co-ordinate preventive measures. The identification of larval sites was a vital part of this programme, which also encouraged the use of house screening and bed nets. They noted that oil and Paris Green were used in larval control in the year 1930s and continue to be the main method of control until 1946. During this period, many larval sites were drained and frequently eucalyptus trees were planted in order to remove permanently any malaria breeding sites.

Brain, Abel, Habila, George, Emmanuel, William, Els, and Frank (2006) opined that malaria remains a major public health problem in sub-Sahara Africa. Though all segments of society are afflicted, children under 5 years of age (U-5) and pregnant women (P-W) suffer most of the morbidity and mortality. They emphasized that the WHO and RBM initiative aims to decrease the burden of malaria disease through three proven interventions.

The first is concerned with the prompt management of presumed malaria cases, that is immediate investigation, diagnosis, treatment or management of persons with malaria diseases. The second is the intermittent preventive treatment of pregnant women. This, according to Thomson (1996) refers to the Nigeria policy on prevention of malaria which recommends giving women of all parities two doses of chloroquine as intermittent preventive treatment (IPT) in the second and third trimester of pregnancy. It has been observed that due to plasmodium resistance to choloroquine, sulfadoxine – pyrimethamine (SP) has been used to replace chloroquine. SP is also given two doses during the second and third trimester (Mayor, Serra-Casas, Sanz, Aponti, Macete, Mandomando, Puvol, Berzosa, Debano, Aide, Sacarlal, Berrito, Alonso, & Mendendez 2008). The third intervention is the wide-spread use of insecticide treated bed nets (ITNs), in which individuals especially pregnant and nursing mothers and children are encouraged to sleep under it to protect them against mosquito bites.

WHO (1997) asserted that in the past decade, much emphasis had been given to adapting existing vector control techniques and developing new methods to enable health personnel, communities and individuals to take action in defence of their own health. Besides, education in recognizing the symptoms has reduced the number of cases in some areas of the developing world by as much as 20 per cent. The report noted that recognizing the disease in the early stage can also stop the disease from becoming a killer. Education can also inform people to cover over areas of stagnant, still water such as water tanks which are ideal breeding grounds for the parasite and mosquitoes, thus cutting down the risk of the transmission between people. Priority has, therefore, been given to the development of simple, safe, appropriate and inexpensive measures for vector control. This resulted in development of insecticide treated bed nets and curtains for the control of mosquitoes and sand flies.

Guyatt and Ochala (2003) defined insecticide treated bed nets as a bed net that has been treated with insecticide to protect against mosquitoes and malaria. They maintained that the provision of insecticide-treated bed nets (ITNs) is universally accepted as an efficacious and essential public health service in most parts of Sub-Saharan African malaria endemic areas. On the other hand, Olusola, Moshe and Olayemi (2008) defined a mosquito net as an insecticide....

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