School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Program in Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA 92697, USA.
Int Health. 2023 May 2;15(3):289-298. doi: 10.1093/inthealth/ihac024.
BACKGROUND: Insecticide-treated net (ITN) use is among the most recommended strategies to prevent malaria in pregnancy. We analysed the regional and socio-economic patterns of ITN use among pregnant women in Kenya using data from the 2003, 2008 and 2014 Kenyan Demographic and Health Surveys (KDHSs). METHODS: Inequality was assessed using four dimensions: economic status, education, place of residence and region. Both relative and absolute summary measures were applied. In addition, simple and complex summary measures, i.e. difference, population attributable fraction, population attributable risk and ratio were considered based on the number of subgroups in each variable. RESULTS: There was overt inequality in the use of ITNs among pregnant women, with greater use among the better-off group in 2003 and 2014. Greater ITN use was also observed among pregnant women with a higher level of education. Pregnant women from urban settings tended to use ITNs (slept under a net the night before the survey) more than their rural counterparts in the 2003 KDHS. There were significant regional variations across the three surveys in all inequality summary measures, except ratio in the 2014 survey. CONCLUSIONS: Significant inequality in ITN use among pregnant women was observed at a macro scale.
背景:经杀虫剂处理的蚊帐(ITN)的使用是预防孕妇疟疾的最推荐策略之一。我们使用肯尼亚 2003、2008 和 2014 年肯尼亚人口与健康调查(KDHS)的数据,分析了肯尼亚孕妇使用 ITN 的区域和社会经济模式。
方法:使用四个维度评估不平等:经济状况、教育、居住地和地区。应用了相对和绝对总结措施。此外,还根据每个变量的子组数量考虑了简单和复杂的总结措施,即差异、人群归因分数、人群归因风险和比值。
结果:孕妇使用 ITN 存在明显的不平等,2003 年和 2014 年富裕群体的使用率更高。教育程度较高的孕妇使用 ITN 的比例也更高。在 2003 年 KDHS 中,城市地区的孕妇比农村地区的孕妇更倾向于使用 ITN(在调查前一天晚上睡在蚊帐下)。在所有不平等总结措施中,除了 2014 年调查中的比值外,三个调查之间都存在显著的区域差异。
结论:在宏观层面观察到孕妇使用 ITN 存在显著的不平等。
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