Ownership, Coverage, Utilisation and Maintenance of Long-lasting insecticidal nets in Three Health Districts in Cameroon: A Cross-Sectional Study

ABSTRACT

The Bamenda, Santa and Tiko Health Districts are in the highest malaria transmission strata of Cameroon. The purpose of this study was to explore the indicators of ownership and utilisation as well as maintenance of long-lasting insecticidal nets (LLINs) in three health districts in Cameroon. A cross-sectional household survey involving 1,251 households was conducted in the Bamenda, Santa and Tiko Health Districts in Cameroon. A structured questionnaire was used to collect data on LLINs ownership, utilisation, and maintenance as well as demographic characteristics. The average number of LLINs per household was higher in the Bamenda Health District (BHD) compared to the Tiko Health District (THD) (2.5±1.4 vs 2.4±1.6) as well as the household ownership of at least one LLIN (93.3% vs. 88.9%). The proportion of the de facto population with universal utilisation was higher in BHD compared to THD (13.1% vs 0.2%). In multinomial regression analysis, households in the Santa Health District (SHD) (OR = 0.4, 95% = C.I; 0.2 – 0.8, p = 6.10×10⁻³), were less likely to own at least one LLIN, while those in the BHD (OR = 1.3, 95% = C.I; 0.8 – 2.1, p = 0.33) were more likely to maintain LLINs compared to those in THD. Ownership of LLINs was low in SHD and THD in comparison to the goal of one LLIN for every two household members. Overall, LLINs coverage and accessibility was still low after the free Mass Distribution Campaigns, making it difficult for all household members to effectively use LLINs.