title: Who sleeps under bednets in Ghana? A doer/non-doer analysis of malaria prevention behaviours.
abstract: BACKGROUND
  Malaria prevention programmes should be based in part on knowledge of why some individuals use bednets while others do not. This paper identifies factors and characteristics of women that affect bednet use among their children less than five years of age in Ghana.
  
  
  METHODS
  Data come from the baseline component of an evaluation of Freedom from Hunger's malaria curriculum. A quasi-experimental design was used to select clients (n = 516) of Credit with Education (an integrated package of microfinance and health education) and non-clients (n = 535). Chi-squares, Fisher's Exact tests and logistic regression were used to compare the characteristics of mothers whose children use bednets (doers) with those whose children do not (non-doers) and to identify factors associated with bednet use among children less than five years of age.
  
  
  RESULTS
  The following factors were most closely associated with bednet use: region of residence; greater food security; and caregivers' beliefs about symptoms, causation and groups most vulnerable to malaria. Most respondents knew mosquitoes caused malaria; however, 20.6% of doers and 12.3% of non-doers (p = .0228) thought overworking oneself caused malaria. Ninety percent of doers and 77.0% of non-doers felt that sleeping under a net was protective against malaria (p = .0040). In addition, 16.5% of doers and 7.5% of non-doers (p = .0025) identified adult males as most vulnerable to malaria.
  
  
  CONCLUSIONS
  Greater knowledge about malaria does not always translate into improved bednet use. Though culturally-based ideas about malaria may vary between communities, integrating them into traditional health education messages may enhance the effectiveness of public health efforts.
authors.affiliation: Department of Health Science, Brigham Young University, Provo, UT, USA. nataliedelacruz@gmail.com
authors.forename: Natalie
authors.initials: N
authors.lastname: De La Cruz
authors.forename: Benjamin
authors.initials: B
authors.lastname: Crookston
authors.forename: Kirk
authors.initials: K
authors.lastname: Dearden
authors.forename: Bobbi
authors.initials: B
authors.lastname: Gray
authors.forename: Natasha
authors.initials: N
authors.lastname: Ivins
authors.forename: Stephen
authors.initials: S
authors.lastname: Alder
authors.forename: Robb
authors.initials: R
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D001512:Bedding and Linens; D002675:Child, Preschool; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006266:Health Education / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007306:Insecticides / Q000494:pharmacology; D016015:Logistic Models; D008288:Malaria / Q000517:prevention & control* / Q000523:psychology*; D008875:Middle Aged; D009032:Mosquito Control / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
chemical_list: D007306:Insecticides