From October 17 through November 1, 2006, members of 2,059 households were interviewed out of 2,100 targeted. Of the 100 enumeration areas, 85% were classified as rural and 15% as urban, mirroring the characteristics of the 46 campaign districts. On a weighted basis, households with CU5s represented 51.7% of all households in the survey population. Among sampled households, 78.0% had a woman of reproductive age; of these, 37.1% did not have a CU5 (95% CI: 34.7, 39.6%). An estimated 8.3% of the women in the population reported themselves to be pregnant.
Before vs. after campaign comparisons for key indicators
The survey estimated that 3.63 million LLINs were distributed (95% CI: 3.39, 3.87 million), of which 3.38 million were distributed to CU5s (93.9%) (Table ). The campaign increased the number of bed nets owned by 50%, from 7.2 to 10.9 million. Households owning only campaign nets were 13.8% of all households, which was over one-third of all households receiving campaign nets. Pre-campaign ITN household ownership could be estimated as 36.9% = 50.7 (post-campaign ITN/LLIN HH ownership) -13.8% (households that only owned campaign nets in the survey), and similarly pre-campaign household ownership of any bed net could be estimated at 53.1% (66.9-13.8%). Prior to the campaign, socially marketed nets represented 68.7% of all nets owned. This represents approximately 5.0 million nets (7.24 million* 0.687). After the campaign, they represented 46.0% of all nets owned. Figure presents the distribution of bed net brand ownership before and after the campaign.
Key indicators, before and after the campaign *
Distribution of bed net brands owned before and after the campaign*. * Pre-campaign: Number of bed nets = 2,105, Post-Campaign: Number of bed nets = 3,141.
The campaign increased ITN ownership for HH with CU5s by 28.7% (from 46.7% to 74.4%, p < .0001). It increased ITN ownership for HH with women of reproductive age by 18.6% (from 40.3% to 58.9%).
Prior to the campaign, the percent of all nets in households with CU5s that were ITN increased with the wealth quintile. However, even in the wealthiest quintile, less than a third of the homes owned ITNs. After the campaign, the relationship between ITN ownership and wealth disappeared. The smallest increase in ITN ownership was in the wealthiest quintile, 25.5%,. The other wealth quintiles had increases of nearly 40% or more. The increases in all wealth quintiles were statistically significant (p < .001 for all quintiles, Table ).
Percent of all bed nets in households with children under 5 that were ITNs (including LLINs) by wealth quintile before and after the campaign.*
The equity ratio for all households receiving campaign bed nets was 1.59 (95% CI: 1.29, 1.89). This means that the poorest households were 59% more likely to receive campaign bed nets than the wealthiest households. The equity ratio for CU5s, women of reproductive age, and pregnant women sleeping under an ITN the previous night were all less than 0.8. This means that despite the campaign, the target populations in the wealthiest quintiles were all 20% or more likely to be sleeping under an ITN. Equity ratios with 95% confidence intervals are presented in Figure .
Figure 3 Equity ratios for selected indicators*. *An equity ratio of more than 1 means that the poorest quintile was more likely to receive the intervention, less than 1 means that the wealthiest quintile was more likely to receive the intervention. Sample sizes: (more ...)
There were 3141 bed nets in the 2059 households in the survey. Over half of households surveyed (n = 1080) owned ITNs. One third of all nets were campaign nets. During the survey, 70% of all nets were seen by the interviewers. Summary data with 95% confidence intervals are presented in Table .
Survey estimates related to bed nets*
Among all bed nets, 66.2% were either treated in the last six months (ie, were ITNs) or were LLINs. More than half (54.8%) of all nets were LLINs. Among all bed nets, 43.1% were obtained at no cost. Nearly two-thirds (67.1%) of all nets were hanging. About a third (30.6%) of all nets were obtained at health facilities (other than as a part of the campaign), and 24.8% were obtained from dukas (small stores), hawkers, kiosks, or textile shops. Almost ninety percent (88.4%) of nets were classified as being in good condition (no holes, tears). For the most popular brand of socially marketed bed net (a non-LLIN), 30.6% had been treated in the last six months.
About two-thirds (66.9%) of all households had at least one bed net of any kind. Over forty percent (41.9%) of households had more than one bed net. Over half (50.7%) of households owned an ITN, and 39.1% of all households had received a campaign LLIN. ITNs were hanging in 41.9% of all households. In households owning ITNs, 82.6% had at least one ITN hanging. Households that owned only campaign nets were 13.8% of all households, which was over one-third of all households receiving campaign nets. Summary data with 95% confidence intervals are presented in Table .
Survey estimates related to households (HH)*
Households that had neither a CU5 nor a woman of reproductive age comprised 19.2% of all households. In this group, bed net ownership was 16.2% for any ITN, and 33% for any type of bed net. Urban households were more likely than their rural counterparts to have nets of any type. (ITNs: Odds Ratio: 1.37, 95% CI: 1.06, 1.77; Any Net: Odds Ratio: 2.35, 95% CI: 1.70, 2.35). Among all households that received campaign nets, 94.8% had retained all nets and 97.9% percent had retained at least one campaign net. There was no significant variation in retention by malaria transmission zone status.
Children under five
There were 1,727 CU5s living in 1113 households in the survey. Approximately two-thirds (67.5% ) of households with CU5s, received campaign LLINs. The percent of these households receiving campaign LLINs did not vary significantly by region. Just under ninety percent (87.2%) of households with CU5s had a bed net of any type, with 74.4% owning an ITN. Summary data with 95% confidence intervals for households with CU5s are presented in Table .
Survey estimates for Households (HH) with Children under 5 (CU5s)*
Just over half (51.7%) of CU5s (95% CI: 48.8, 54.7%) slept under an ITN during the previous night. This proportion did not vary significantly by age or sex. There was significant variation by malaria zone/geographic region: endemic: 50.3%; epidemic: 41.4%, highland/seasonal 67.9% (p < .0001). In households with CU5s owning ITNs, 69.0% of children slept under them the previous night, and in households with CU5s owning ITNs that were hanging, 83.5% of children slept under them the previous night. Having received a campaign bed net greatly increased the likelihood that a child under 5 slept under an ITN the previous night (67.7 vs. 28.8%, p < .0001). Overall, 56.5% of the ITNs used by CU5s were campaign nets. Summary data with 95% confidence intervals for CU5s are presented in Table .
Survey estimates for Children under 5 (CU5s)*
Women of reproductive age
There were 2,053 women of reproductive age (15-49 years, WORAs) living in 1,613 households. There were 182 pregnant women living in 180 households in the survey. Among pregnant women, 58.4% slept under a net of any type during the previous night (95% CI: 50.9, 65.9%); however, only 36.3% of pregnant women slept under an ITN. (95% CI: 29.0, 43.7%). Among all WORAs, 33.0% slept under an ITN during the previous night (95% CI: 30.6, 35.4%). In households that owned one or more ITNs, 55.9% of women of reproductive age slept under an ITN during the previous night. For pregnant women, this number was 56.7%. Summary data for WORAs with 95% confidence intervals are presented in Table .
Survey estimates for Women of Reproductive Age (WORAs)*