How equitable is bed net ownership and utilisation in Tanzania? A practical application of the principles of horizontal and vertical equity
How equitable is bed net ownership and utilisation in Tanzania? A practical application of the principles of horizontal and vertical equity
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DOI：
10.1186/1475-2875-8-109
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发表时间：
2009-05-21
期刊：
影响因子：
3
通讯作者：
Mwengee, William
中科院分区：
文献类型：
--
作者：
Matovu, Fred;Goodman, Catherine;Mwengee, William
背景：研究表明，疟疾的负担仍然巨大，特别是在低收入环境中。虽然已经推广了驱虫蚊帐等有效的疟疾控制措施，但对这些措施的公平性了解相对较少。了解低收入环境中使用驱虫蚊帐的差异对于扩大疟疾控制方案，特别是驱虫蚊帐的规模十分重要。本文的目的是衡量的程度和原因的不平等的所有权和使用蚊帐的社会经济群体（SEGs）和年龄组在坦加区，坦桑尼亚东北部。方法：问卷调查管理的1,603个家庭的户主从农村和城市地区。使用基于资产的财富指数和户主的教育水平将家庭分为SEG。计算集中指数和基于回归的不平等措施，以分析蚊帐拥有和使用方面的纵向和横向不平等。焦点小组讨论（FGD）被用来探讨社区的观点不平等的causes of inequalities.Results：使用驱虫蚊帐仍然令人震惊的低相比，减少疟疾的目标，80%的覆盖率。在驱虫蚊帐和所有蚊帐的所有权方面存在的不平等现象明显有利于富人，在农村地区更为明显。FGD显示，缺乏资金是不使用驱虫蚊帐的关键因素，其次是对杀虫剂对使用者健康的影响的负面看法。家庭SES，生活在城市地区和五岁以下的正相关与蚊帐的拥有权和/或utilization.Conclusion：结果强调需要大规模分配的驱虫蚊帐;一个社区范围内的计划，以治疗所有未经处理的蚊帐，并促进使用长效驱虫蚊帐（LLINs）或更持久的治疗蚊帐。应通过高补贴计划和大规模分发免费蚊帐，以农村人口和五岁以下儿童为目标。还需要开展公共宣传运动，鼓励人们使用驱虫蚊帐，减少对杀虫剂的负面看法。
Background: Studies show that the burden of malaria remains huge particularly in low-income settings. Although effective malaria control measures such as insecticide-treated nets (ITNs) have been promoted, relatively little is known about their equity dimension. Understanding variations in their use in low-income settings is important for scaling up malaria control programmes particularly ITNs. The objective of this paper is to measure the extent and causes of inequalities in the ownership and utilisation of bed nets across socioeconomic groups (SEGs) and age groups in Tanga District, north-eastern Tanzania.Methods: A questionnaire was administered to heads of 1,603 households from rural and urban areas. Households were categorized into SEGs using both an asset-based wealth index and education level of the household head. Concentration indices and regression-based measures of inequality were computed to analyse both vertical and horizontal inequalities in ownership and utilisation of bed nets. Focus Group Discussions (FGDs) were used to explore community perspectives on the causes of inequalities.Results: Use of ITNs remained appallingly low compared to the RBM target of 80% coverage. Inequalities in ownership of ITNs and all nets combined were significantly pro-rich and were much more pronounced in rural areas. FGDs revealed that lack of money was the key factor for not using ITNs followed by negative perceptions about the effect of insecticides on the health of users. Household SES, living within the urban areas and being under-five were positively associated with bed net ownership and/or utilisation.Conclusion: The results highlight the need for mass distribution of ITN; a community-wide programme to treat all untreated nets and to promote the use of Long-Lasting Insecticidal nets (LLINs) or longer-lasting treatment of nets. The rural population and under-fives should be targeted through highly subsidised schemes and mass distribution of free nets. Public campaigns are also needed to encourage people to use treated nets and mitigate negative perceptions about insecticides.