title: Benefit incidence analysis of free insecticide treated nets distribution in urban and rural communities of Enugu state, South East Nigeria.
abstract: BACKGROUND
  Malaria is a leading cause of mortality as well as a barrier to economic and social development in developing countries. The use of insecticide-treated nets (ITNs) for malaria vector control is effective in controlling malaria attacks in pregnant women and under-5 children. The Nigerian government, in its bid to achieve the Millennium Development Goal (MDG) 4 and 5 distributes free ITNs to pregnant mothers and under-five children in the Roll Back Malaria programme (RBM).
  
  
  OBJECTIVE
  This study compared the benefit incidence analysis of this government program between urban and rural areas.
  
  
  METHODS
  Pretested, semi-structured questionnaires were administered to 150 pregnant women and also 150 mothers of under-5 children, who were randomly selected from each of the two communities (rural and urban) from a local government area (LGA) in Enugu state, Nigeria. The study was conducted within the rainy season periods (March-August) of 2008. The information obtained included some socio-economic variables, accessibility, usage and benefits of usage of ITNs. Data entry and analyses were done using the Statistical Package for Social Sciences (SPSS) version 15.0(Chicago IL, USA). Student's t-test and Chi-square were used for comparison where appropriate. Significant values were taken as P value. Value of less than 0.05 was considered significant.
  
  
  RESULTS
  The respondents' mean monthly expenditures on food utilities and anti-malarials in the rural area and urban areas were N266.1 (74.02), range (143.3-395) and N473 (90) range (380-495.7) respectively (P < 0.001). Within each socio-economic stratum (SES), the average monthly expenditure in the urban community was higher than that of the rural community except for least poor SES (P < 0.05). For the urban community, 106 (71.6%) respondents used ITNs as against 99 (66.9%) in the rural community [P = 0.778, OR = 1.3 (95% CI: 0.76, 2.05)]. Also, ITNs were always accessible to 112 (75.7%) and 54 (36.5%) respondents in the urban and rural communities respectively [P < 0.001, OR = 5.4 (95% CI: 3.28, 8.96)]. In the urban community, 130 (87.7%) respondents expressed some benefit from ITNs as against 123 (83.1%) respondents from the rural community [P = 0.258, OR = 1.5 (95% CI: 0.76, 2.28)].
  
  
  CONCLUSIONS
  Most pregnant women and mothers of under-five children in the rural study area belong to the poorest socio-economic classes and they spend less on anti-malarial treatment. Majority of the free ITN's beneficiaries in both urban and rural study areas have used and benefitted from them.
authors.forename: T U
authors.initials: TU
authors.lastname: Nwagha
authors.affiliation: Department of Obstetrics and Gynecology / Physiology, University of Nigeria, Enugu Campus, Enugu, Nigeria.
authors.forename: U I
authors.initials: UI
authors.lastname: Nwagha
authors.forename: C C
authors.initials: CC
authors.lastname: Dim
authors.forename: U B
authors.initials: UB
authors.lastname: Anyaehie
authors.forename: M
authors.initials: M
authors.lastname: Egbugara
authors.forename: C
authors.initials: C
authors.lastname: Onwasigwe
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D015994:Incidence; D007306:Insecticides; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D009032:Mosquito Control / Q000379:methods*; D009549:Nigeria / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D000962:Antimalarials; D007306:Insecticides