title: Equity in long-lasting insecticidal nets and indoor residual spraying for malaria prevention in a rural South Central Ethiopia.
abstract: BACKGROUND
  While recognizing the recent achievement in the global fight against malaria, the disease remains a challenge to health systems in low-income countries. Beyond widespread consensuses about prioritizing malaria prevention, little is known about the prevailing status of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) across different levels of wealth strata. The aim of this study was to evaluate the socioeconomic related dimension of inequalities in malaria prevention interventions.
  
  
  METHODS
  This study was conducted in July-August 2014 in Adami Tullu district in the South-central Ethiopia, among 6069 households. A cross-sectional data were collected on household characteristics, LLIN ownership and IRS coverage. Principal component analysis technique was used for ranking households based on socioeconomic position. The inequality was measured using concentration indices and concentration curve. Decomposition method was employed in order to quantify the percentage contribution of each socioeconomic related variable on the overall inequality.
  
  
  RESULTS
  The proportion of households with at least one LLIN was 11.6 % and IRS coverage was 72.5 %. The Erreygers normalized concentration index was 0.0627 for LLIN and 0.0383 for IRS. Inequality in LLIN ownership was mainly associated with difference in housing situation, household size and access to mass-media and telecommunication service.
  
  
  CONCLUSIONS
  Coverage of LLIN was low and significant more likely to be owned by the rich households, whereas houses were sprayed equitably. The current mass free distribution of LLINs should be followed by periodic refill based on continuous monitoring data.
authors.affiliation: Center for International Health, University of Bergen, Bergen, Norway. alemayehu4all@gmail.com.|Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia. alemayehu4all@gmail.com.
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Hailu
authors.affiliation: Center for International Health, University of Bergen, Bergen, Norway.
authors.forename: Bernt
authors.initials: B
authors.lastname: Lindtjørn
authors.affiliation: Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Wakgari
authors.initials: W
authors.lastname: Deressa
authors.affiliation: School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia.
authors.forename: Taye
authors.initials: T
authors.lastname: Gari
authors.affiliation: School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia.
authors.forename: Eskindir
authors.initials: E
authors.lastname: Loha
authors.affiliation: Center for International Health, University of Bergen, Bergen, Norway.|Center for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway.
authors.forename: Bjarne
authors.initials: B
authors.lastname: Robberstad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005191:Family Characteristics; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data*; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods*; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Concentration index; Equity; Ethiopia; IRS; Inequality analysis; LLIN; Malaria prevention