title: Education attainment of head of households associated with insecticide-treated net utilization among five to nineteen-year old individuals: evidence from the malaria indicator survey 2010 in Zambia.
abstract: BACKGROUND
  Education attainment may be a factor potentially influencing health-seeking behaviour of individuals. The effect of the level of education attainment of head of households of five to nineteen year old individuals in Zambia on ITN utilization was investigated.
  
  
  METHODS
  Data stem from the 2010 Malaria Indicator Survey, which covered the entire Zambia, was used in this study. Of the total number of five to 19-year olds (n = 7,429), only 65% (4, 810) met the inclusion criteria for this study. The education level of the head of households was taken as a household variable and was categorized as "never been to school" for those who had never enrolled in school, Primary for Grades 1 to 7, Secondary for Grades 8 to 12 and Tertiary for beyond Grade 12. Multivariate Logistic regression was used to determine adjusted odds ratios that estimated the effect of education on ITN utilization after controlling for residence, sex, age group and other background factors.
  
  
  RESULTS
  Overall (n = 4,810), 48.5% were males and 51.5% were females with the median age of 10 years and 11 years respectively. The ITN utilization among the five to 19 year old individuals from households with the head having Primary and Secondary education were not statistically significant from those who came from households where the head had never been to school. However, those who came from households with the head having tertiary education attainment were 1.7 times more likely to have slept under an ITN a night before the survey than those from households headed by individuals who never attended school or had primary education. (AOR, 1.69; 95% CI, 1.19-2.41). Of the eligible population, 35% were excluded from the study due to incomplete records.
  
  
  CONCLUSIONS
  The findings suggest that tertiary education of the head of head of the household might be important in influencing health behaviour of the members of households. Therefore, health education messages focussing on strategies that aim to increase ITN utilization need to account for these differential variations associated with education attainment in communities.
authors.affiliation: Department of Public Health, School of Medicine, University of Zambia, P,O Box 50110, Lusaka, Zambia. sichandem@gmail.com.
authors.forename: Mwamba
authors.initials: M
authors.lastname: Sichande
authors.forename: Charles
authors.initials: C
authors.lastname: Michelo
authors.forename: Hikabasa
authors.initials: H
authors.lastname: Halwindi
authors.forename: John
authors.initials: J
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D004493:Education / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data*; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D015024:Zambia