Spatial distribution of bednet coverage under routine distribution through the public health sector in a rural district in Kenya.
Abstract
Insecticide-treated nets (ITNs) are one of the most important and cost-effective tools
for malaria control. Maximizing individual and community benefit from ITNs requires
high population-based coverage. Several mechanisms are used to distribute ITNs, including
health facility-based targeted distribution to high-risk groups; community-based mass
distribution; social marketing with or without private sector subsidies; and integrating
ITN delivery with other public health interventions. The objective of this analysis
is to describe bednet coverage in a district in western Kenya where the primary mechanism
for distribution is to pregnant women and infants who attend antenatal and immunization
clinics. We use data from a population-based census to examine the extent of, and
factors correlated with, ownership of bednets. We use both multivariable logistic
regression and spatial techniques to explore the relationship between household bednet
ownership and sociodemographic and geographic variables. We show that only 21% of
households own any bednets, far lower than the national average, and that ownership
is not significantly higher amongst pregnant women attending antenatal clinic. We
also show that coverage is spatially heterogeneous with less than 2% of the population
residing in zones with adequate coverage to experience indirect effects of ITN protection.
Type
Journal articleSubject
Cluster AnalysisFamily Characteristics
Female
Geography
Health Facilities
Humans
Infant
Insecticide-Treated Bednets
Kenya
Models, Biological
Mosquito Control
Multivariate Analysis
Ownership
Pregnancy
Public Health
Public Sector
Regression Analysis
Rural Population
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https://hdl.handle.net/10161/5957Published Version (Please cite this version)
10.1371/journal.pone.0025949Publication Info
O'Meara, Wendy Prudhomme; Smith, Nathan; Ekal, Emmanuel; Cole, Donald; & Ndege, Samson (2011). Spatial distribution of bednet coverage under routine distribution through the public
health sector in a rural district in Kenya. PLoS One, 6(10). pp. e25949. 10.1371/journal.pone.0025949. Retrieved from https://hdl.handle.net/10161/5957.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Wendy P O'Meara
Associate Professor of Medicine
Dr. Wendy O’Meara is an Associate Professor at Duke University School of Medicine
in the Division of Infectious Diseases, visiting professor at Moi University, and
the Associate Director for Research of the Duke Global Health Institute. She has been
based full-time in Kenya since 2007.
Dr. O’Meara’s team is interested in improving rational drug use for suspected malaria
fevers through expanding the use of diagnostic tools in the community and in health
facilities. As

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