Fundamental Cause Theory and Public Health Interventions: Urban–Rural Variations in ITN Use Among Women of Reproductive Age in Nigeria.
1
Sociology and Criminology, University of Miami, Miami, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Malaria is an endemic disease significantly impacting health outcomes in Nigeria, with both urban and rural populations experiencing high infection rates despite decades of interventions. Women of reproductive age face disproportionate vulnerability due to socioeconomic and environmental conditions that shape access to preventive resources such as insecticide-treated nets (ITNs). Fundamental cause theory (FCT), the conceptual framework for this study, posits that social conditions, including wealth, education, and urban-rural, serve as persistent drivers of health inequality by determining access to flexible resources such as knowledge, money, power, and public health information. Few studies explore how social inequalities affect ITN use. This study investigates how social conditions and flexible resources contribute to urban–rural variation in ITN use among women of reproductive age in Nigeria.
METHODS:
This study will utilize secondary data from the 2021 Nigeria demographic and health survey (DHS). Hierarchical logistic regression will be employed to assess how socioeconomic indicators, wealth, education, and urban-rural influence ITN use and to evaluate the mediating role of flexible resources, including malaria knowledge, internet access, and exposure to malaria information at both individual and community levels. Contextual variables, including environmental factors such as ethnicity, will be incorporated to capture broader social conditions.
RESULTS:
Expected findings suggest that women with higher socioeconomic status and greater access to flexible resources will demonstrate a higher likelihood of ITN use. Urban–rural differences are expected to reflect unequal distribution of knowledge, media exposure, and health interventions. Interaction effects, such as ethnicity by wealth, are expected to reveal differential advantages in resource use across social groups.
CONCLUSIONS:
Guided by FCT, this study highlights how structural inequalities shape ITN use beyond individual behavior. Findings will inform more equitable malaria prevention strategies by emphasizing interventions that address the social conditions limiting women’s ability to protect themselves from malaria.
Malaria is an endemic disease significantly impacting health outcomes in Nigeria, with both urban and rural populations experiencing high infection rates despite decades of interventions. Women of reproductive age face disproportionate vulnerability due to socioeconomic and environmental conditions that shape access to preventive resources such as insecticide-treated nets (ITNs). Fundamental cause theory (FCT), the conceptual framework for this study, posits that social conditions, including wealth, education, and urban-rural, serve as persistent drivers of health inequality by determining access to flexible resources such as knowledge, money, power, and public health information. Few studies explore how social inequalities affect ITN use. This study investigates how social conditions and flexible resources contribute to urban–rural variation in ITN use among women of reproductive age in Nigeria.
METHODS:
This study will utilize secondary data from the 2021 Nigeria demographic and health survey (DHS). Hierarchical logistic regression will be employed to assess how socioeconomic indicators, wealth, education, and urban-rural influence ITN use and to evaluate the mediating role of flexible resources, including malaria knowledge, internet access, and exposure to malaria information at both individual and community levels. Contextual variables, including environmental factors such as ethnicity, will be incorporated to capture broader social conditions.
RESULTS:
Expected findings suggest that women with higher socioeconomic status and greater access to flexible resources will demonstrate a higher likelihood of ITN use. Urban–rural differences are expected to reflect unequal distribution of knowledge, media exposure, and health interventions. Interaction effects, such as ethnicity by wealth, are expected to reveal differential advantages in resource use across social groups.
CONCLUSIONS:
Guided by FCT, this study highlights how structural inequalities shape ITN use beyond individual behavior. Findings will inform more equitable malaria prevention strategies by emphasizing interventions that address the social conditions limiting women’s ability to protect themselves from malaria.
| eISSN: | 2654-1459 |
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