Masterarbeit, 2017
103 Seiten
CHAPTER ONE: INTRODUCTION
1.1 CHAPTER OVERVIEW
1.2 BACKGROUND
1.3 BURDEN AND CONSEQUENCES OF MALARIA IN PREGNANCY
1.4 MALARIA CONTROL STRATEGIES IN PREGNANT WOMEN
1.5 JUSTIFICATION OF THE STUDY
1.6 RESEARCH QUESTION
1.7 AIMS OF THE STUDY
1.8 CHAPTER SUMMARY
CHAPTER TWO: LITERATURE REVIEW
2.1 CHAPTER OVERVIEW
2.2 CONCEPTUALIZATION OF THE RESEARCH QUESTION AND LITERATURE SEARCH METHOD
2.3 EVOLUTION OF POLICIES AND STRATEGIES FOR MALARIA PREVENTION AND CONTROL
2.4 CURRENT STRATEGIES FOR MALARIA PREVENTION AND CONTROL
2.4.1 VECTOR CONTROL
2.4.1.1 Insecticide-treated Mosquito Nets
2.4.1.2 Indoor Residual Spray (IRS)
2.4.2 EARLY DIAGNOSIS AND TREATMENT
2.4.3 INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY (IPTs)
2.5 BEHAVIOURAL CHANGE THEORIES
2.6 FACTORS INFLUENCING ITN USE BY PREGNANT WOMEN
2.6.1 Knowledge of the health condition
2.6.2 Socio-demographic Factors
2.6.3 Socio-economic Factors
2.6.4 Education
2.6.5 Misconceptions
2.6.6 Access/Availability
2.6.7 Others
2.7 CHAPTER SUMMARY
CHAPTER THREE: METHODOLOGY
3.1 CHAPTER OVERVIEW
3.2 STUDY DESIGN AND PHILOSOPHY
3.2.1 Evidence-Based Practice (EBP)
3.2.2 Systematic Reviews (SRs) and Evidence-Based Practice
3.2.3 Advantages of Systematic Reviews
2.2.4 Limitations of Systematic Reviews
2.2.4 Secondary Data Analysis
3.3 METHODS
3.3.1 Search Strategy
3.3.2 Conducting the Search
3.3.3 Refining the Search
3.3.3.1 Inclusion and Exclusion Criteria
3.3.4 Final Selection of Seven Studies
3.3.5 Quality Assessment
3.4 DATA EXTRACTION AND SYNTHESIS
3.5 CHAPTER SUMMARY
CHAPTER FOUR: FINDINGS
4.1 CHAPTER OVERVIEW
4.2 DATA EXTRACTION AND SYNTHESIS
4.3 RESULTS
4.3.1 CHARACTERISTICS OF APPRAISED STUDIES
4.3.1.1 Overview of study designs and methods
4.3.1.2 Location /Context setting
4.3.1.3 Sampling and Population Characteristics
4.3.1.4 Data collection
4.3.1.5 Approaches to data analysis
4.3.1.6 Ethics
4.4 OVERVIEW OF STUDY FINDINGS
4.4.1 SOCIO-DEMOGRAPHIC FACTORS
4.4.2 LEVEL OF KNOWLEDGE
4.4.3 SOCIO- ECONOMIC FACTORS
4.4.4 MISCONCEPTIONS
4.4.5 OTHERS
4.5 CHAPTER SUMMARY
CHAPTER FIVE: DISCUSSION
5.1 CHAPTER OVERVIEW
5.2 DISCUSSION OF RESULTS
5.2.1 SOCIO-DEMOGRAPHIC FACTORS
5.2.2 LEVEL OF KNOWLEDGE
5.2.3 SOCIOECONOMIC FACTORS
5.2.4 MISCONCEPTIONS
5.2.5 ACCESS/AVAILABILITY
5.3 DISCUSSION IN RELATION TO RESEARCH QUESTION AND OBJECTIVES
5.4 CHAPTER SUMMARY
CHAPTER SIX: CONCLUSION
6.1 CHAPTER SUMMARY
6.2 SUMMARY OF FINDINGS
6.3 GAPS IN LITERATURE AND RECOMMENDATIONS FOR FURTHER STUDY
6.4 IMPLICATIONS OF THE STUDY WITH REGARDS TO POLICY AND PRACTICE
6.5 LIMITATIONS OF THE REVIEW
6.6 REFLEXIVITY
6.7 CHAPTER SUMMARY
This dissertation aims to systematically appraise existing primary research to identify the various factors that influence the utilization of insecticide-treated nets (ITNs) among pregnant women in Nigeria, ultimately formulating a conceptual map of these determinants.
2.6 FACTORS INFLUENCING ITN USE BY PREGNANT WOMEN
Factors that have been identified to influence ITN utilization are numerous but can be broadly categorized into the following; knowledge of the health condition, socio-demographic factors, misconceptions and access.
2.6.1 Knowledge of the health condition
Several studies have identified the presence of correlation between the level of knowledge about malaria and its preventive measures and the utilization of ITNs among pregnant women across varied socio-demographic groups (Russel et al., 2015; Ankomah et al.,2012; Arogundade et al., 2011). Pregnant women generally receive health education including information on malaria prevention and control during antenatal care visits to health facilities (Amako, 2016). This service is generally provided by doctors, nurses, midwives and other auxiliary staff in English language and the local dialect of the community (Fagbamigbe and Idemudia, 2015)
Arogundade et al., (2011) found that one of the key predictors of ITN use among pregnant women in Nigeria is the knowledge that ITN use prevents malaria. Pregnant women who knew about the specific risks of malaria in pregnancy (such as anaemia, low birth weight, abortion) were more likely to use ITNs than those who did not. This is similar to what was obtained by Russel et al., (2015) and Belay and Deressa, (2008). However, Russel et al., (2015) found that despite knowing that mosquitoes cause malaria, only 2.3% of the respondents knew that malaria could result in spontaneous abortion, stillbirth, prematurity or intrauterine growth restriction.
Further evidence has also shown that education and correct knowledge about malaria, its modes of prevention as well as its fatal consequences were found to be significantly associated with increased use (Arogundade et al., 2011; Deressa et al., 2011). However, Aluko and Oluwatosin (2012) found that despite the relatively high knowledge of malaria by the respondents, the use of ITN is significantly low. This has been attributed to the negative attitudes of the respondents to ITN use, poverty or unavailability.
CHAPTER ONE: INTRODUCTION: This chapter introduces the research context, justifying the need to study factors influencing ITN utilization in Nigeria and defining the study's aims and research questions.
CHAPTER TWO: LITERATURE REVIEW: This chapter reviews the literature on malaria prevention policies, behavioural change theories, and identified factors influencing ITN use among pregnant women.
CHAPTER THREE: METHODOLOGY: This chapter outlines the study's philosophy, focusing on Evidence-Based Practice (EBP) and systematic review procedures, including search strategies and quality assessment.
CHAPTER FOUR: FINDINGS: This chapter presents the data extracted from the seven selected primary studies, categorized into themes like socio-demographic, socio-economic, and knowledge-based factors.
CHAPTER FIVE: DISCUSSION: This chapter critically discusses the findings, relating them to existing literature and presenting a conceptual map of the interrelated factors affecting ITN utilization.
CHAPTER SIX: CONCLUSION: This chapter summarizes findings, addresses gaps in the literature, provides recommendations for future study, and outlines policy implications.
Malaria, Pregnancy, Nigeria, Insecticide-Treated Nets, ITN, Public Health, Systematic Review, Antenatal Care, Socio-economic Factors, Knowledge, Misconceptions, Evidence-Based Practice, Maternal Health, Malaria Control, Utilization
The research focuses on identifying the facilitators and inhibitors that affect the utilization of insecticide-treated nets (ITNs) among pregnant women in Nigeria.
The work covers socio-demographic characteristics, level of knowledge regarding malaria, common misconceptions, socio-economic factors, and access to healthcare services.
The study seeks to answer: "What factors influence the utilization of Insecticide Treated Nets (ITNs) among pregnant women in Nigeria?"
The researcher conducted a systematic appraisal of seven high-quality primary studies, utilizing quantitative data extraction and narrative synthesis methods.
The main body examines existing literature on malaria prevention, explains the methodology of systematic reviews, details the characteristics of selected primary studies, and synthesizes findings into a conceptual model.
Key terms include Malaria, Pregnancy, Nigeria, ITN, Public Health, Maternal Health, and socio-economic factors.
The study highlights that financial independence and higher social class are strong predictors of ITN use, whereas lower socio-economic status often results in inability to afford nets or reliance on husband's consent.
The map visually demonstrates that ITN utilization is not influenced by a single factor, but by a complex, interrelated web of socio-demographic, economic, and knowledge-based determinants.
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