ACCESS TO, AND UTILISATION OF MALARIA PREVENTION INFORMATION AMONG RURAL DWELLERS IN OYO AND OSUN STATES, NIGERIA

Abstract

Malaria is a major health challenge in Nigeria and many studies have focused on aspects of its prevention. However, scant attention has been given to the content of prevention information and how people at the grassroots access and utilise it. Therefore, access to, and utilisation of malaria prevention information among rural dwellers in Oyo and Osun States, Nigeria were examined with a view to establishing suitability of the information for the rural dwellers. Social Marketing, Diffusion of Innovations and the Health Belief Model were adopted as framework. Content analysis, survey and interpretive designs were used. Oyo and Osun States were purposively selected based on differentials in malaria Advocacy, Communication and Social Mobilisation (ACSM) activities. Random sampling technique was used to select five rural Local Government Areas (LGAs), while two rural communities with primary health centres from the LGAs were selected purposively. A questionnaire was administered on 2,200 respondents (in households) and 16 focus group discussions were held (with men, women and expectant mothers) in primary health centres across the 20 rural communities. Eight key informant interviews were conducted with officials engaged in ACSM. Six radio jingles on malaria prevention, three generic posters and two charts were content analysed. The charts were Roll Back Malaria’s (RBM) Interpersonal Communication (IPC) Chart (Osun State) and Interpersonal Communication Flip Chart for Malaria Control in the Community (IPCFCMC) by Malaria Action Programme for States (Oyo State). The generic posters were Disease Prevention, Take Good Care of Your Net and NetSafe (Oyo and Osun States). Quantitative data were analysed using descriptive statistics, while qualitative data were subjected to explanation building technique. Respondents accessed information on malaria prevention through health officers (55.1%), television (47.0%), community volunteers (45.3%) and radio (44.3%). There were, however, high indicators of utilisation of malaria prevention information: regular sanitation of environment (76.2%), washing of nets (65.1%), sleeping under insecticidal treated nets (62.4%), and willingness to see a medical doctor at the onset of malaria (80.5%). Radio jingles (78.1%), IPC Guide (82.0 %), IPCFCMC (74.1%) and generic posters (64.0%) showed high level of suitability for the rural dwellers. Two messages; ‘Malaria in Pregnancy’ (40.5%) and ‘What is the Way out?’ (35.1%) in IPCFCMC and ‘Disease Prevention’ (35.1%), with culturally inappropriate models and ambiguous illustrations, were not suitable for use. Respondents (62.7%) understood Artemisinin-based Combination Therapy as the combination of drug recommended for the treatment of malaria. Discussants were not quite exposed to the contents of flip charts on malaria prevention communication, and could not recall messages unless prompted. There was a good understanding of the signs and symptoms of malaria. Expectant mothers were primed about the dangers of malaria-in-pregnancy. Insufficient funding, lack of coordination between the states and RBM partners, and a weak ACSM restricted access to malaria prevention information. Despite average access to malaria prevention information through health personnel, mass media, and the unsuitability of some messages in malaria information charts, rural residents in Oyo and Osun States exhibited high rate of utilisation of prevention messages.