Study Setting
Bayelsa State is one of the states that made up the Niger Delta region of southern Nigeria. It shares boundaries with Delta State to the West and North, Rivers State to the East, and the Atlantic Ocean to the South. Bayelsa State is located in a tropical rainforest, with more than three quarters of the area covered by water. The area lies almost entirely below sea level, with a maze of meandering creeks and mangrove swamps. Bayelsa State has 2 tertiary hospitals: Federal Medical Centre, Yenagoa and Niger Delta University Teaching Hospital, Okolobiri
This study was carried out in Federal Medical Centre Yenagoa (FMCY), Bayelsa State. FMCY is located in the capital city of Yenagoa. It attracts patients of diverse socio-economic status because of the high quality of services they offer, at a fair cost. FMCY offers antenatal care to pregnant women, with the clinic being manned by Consultant Obstetricians and resident doctors, on Monday through Thursday. Between 200 and 250 pregnant women are attended to at the antenatal clinic weekly. Presently, clients at the antenatal clinic have to procure drugs for IPTp on their own, and insecticide-treated nets are also currently not being distributed freely during antenatal clinics.
Study Design And Population
We conducted a hospital based cross-sectional study among women attending antenatal care at FMC Yenagoa. We included any pregnant woman attending antenatal clinic at Federal Medical Centre, Yenagoa. Those who were too ill to take part in the study were excluded.
Sample Size And Sampling Method
A sample size of 297 was calculated using a prevalence of 22.4% 10, at confidence level of 95%, and a precision of 5%. Pregnant women were recruited by systematic sampling until the desired sample size was reached. The sampling interval was determined by dividing the sample frame (total number of pregnant women in the antenatal clinic attendance register in FMCY within the month preceding the start of the study) by the sample size (297). According to the hospital report, the average patient flow for the antenatal clinic that month was 823. The kth value was 823/297 which is equal to 2.7, so every 3rd woman was asked, with the starting point determined randomly. Respondents were recruited daily from the antenatal clinics which run on Monday through Thursday, over a duration of 3 months (March to May 2019)
Data Collection Methods
A pre-tested structured interviewer administered questionnaire adapted from the MIS 2015 questionnaire,7 was used to collect data on sociodemographic characteristics of respondents, ownership/use of LLINs, as well as source of LLINs used. Pre-testing of the questionnaires was done at the Diete Koki Memorial Hospital, Yenagoa, a secondary health care facility that caters for both new and referred cases, in order to exclude ambiguities. Thereafter, identified problems in the questionnaire were addressed. The data collection was conducted by trained research assistants.
Measurement Of Variables
The dependent variables for this study was ever use of LLIN by respondents which we defined as having ever used LLIN in course of their pregnancy, while the independent variables were age, marital status, level of education, place of residence (urban or rural), parity, and income level.
Utilization rate was calculated using respondents who actually slept under an LLIN the night prior to the interview.
Data analysis
Epi-Info version 7.3. and Microsoft Excel were used for the data analysis. We estimated the LLIN ownership and utilization. We examined the relationship between the use of LLIN and sociodemographic characteristics using Chi Square. To identify the predictors of use of LLIN, variables p value of 0.1 or lower in bivariate analysis were included in the logistic regression model at 5% level of significance.
Ethical Consideration
We obtained ethical approval to carry out the study from the Ethical review committee of Federal Medical Centre, Yenagoa (approval reference number: FMCY/REC/ECC/2019/JAN/149) A written informed consent was obtained from all respondents by way of signing or thumb printing on the informed consent form, after the nature and objectives of this study were explained to them. Participation was completely voluntary. The respondents’ right to refuse participation in the study was duly respected and was not allowed to affect the care they received in the health facility in any way. All information collected for the study was treated as confidential and stored in a computer with password protection