Predictors of access and utilization to malaria preventive intervention for under-five children in flood-affected region in southern nigeria
1
Sydani Institute of Research and Innovation, Sydani Group, Abuja, Nigeria
2
Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A1541
ABSTRACT
INTRODUCTION:
Malaria remains Nigeria's leading killer of children under-five, causing roughly 30% of under-five deaths in the country[1]. Concurrently, increasingly intense floods destroy facilities, displace families, and create ideal mosquito breeding conditions, amplifying malaria risk while cutting off access to carel2,3]. Yet little is known about how caregivers in Southern Nigeria navigate preventive interventions for under-fives in these flood-affected States.[4]
METHODS:
The study employed a quantitative cross-sectional design using a multistage sampling to select 1387 caregivers of children under-five from the flood-affected southern Nigeria. Data was collected from May to June 2024 using a structured computer-assisted personnel interviews. Analysis was performed using STATA 17; univariate analysis included descriptive statistics, while the bivariate analysis assessed factors associated with access. Multivariate analysis identified predictors at p<0.05.
RESULTS:
Overall, 42.5% of children under-five had received LLINs(Long insecticide-treated nets), and 44.3% had received malaria preventive drugs in the preceding 12 months; 59.4% slept under an LLIN the previous night, while 38.4% had never used preventive drugs, highlighting substantial gaps between access and utilization. Bivariate analysis showed higher access among caregivers with secondary education, higher income, semi-rural/rural residence, Delta/Rivers residence, and those not admitted in the past year. In multivariate models, reduced access was predicted by hospitalization in the past year (AOR=0.41, 95% CI: 0.30–0.54, p<0.001), while income (10–30k: AOR=1.97; >30k: AOR=3.38, both p<0.001) and semi-urban/rural residence (AOR=2.97 and 2.16, respectively) independently increased access. For utilization, higher income (10–30k: AOR=2.57; >30k: AOR=3.87, p<0.001) and all non-urban residences (semi-urban, semi-rural, rural) significantly increased use.
CONCLUSIONS:
Flood-affected communities in Southern Nigeria show substantial gaps between access to and utilization of malaria preventive interventions for children under-five. Limited access due to flooding strongly constrains utilization, undermining malaria control. Strengthening routine provision, prioritizing poor urban households, and integrating flood-responsive distribution systems are essential to reduce malaria morbidity and mortality.
Malaria remains Nigeria's leading killer of children under-five, causing roughly 30% of under-five deaths in the country[1]. Concurrently, increasingly intense floods destroy facilities, displace families, and create ideal mosquito breeding conditions, amplifying malaria risk while cutting off access to carel2,3]. Yet little is known about how caregivers in Southern Nigeria navigate preventive interventions for under-fives in these flood-affected States.[4]
METHODS:
The study employed a quantitative cross-sectional design using a multistage sampling to select 1387 caregivers of children under-five from the flood-affected southern Nigeria. Data was collected from May to June 2024 using a structured computer-assisted personnel interviews. Analysis was performed using STATA 17; univariate analysis included descriptive statistics, while the bivariate analysis assessed factors associated with access. Multivariate analysis identified predictors at p<0.05.
RESULTS:
Overall, 42.5% of children under-five had received LLINs(Long insecticide-treated nets), and 44.3% had received malaria preventive drugs in the preceding 12 months; 59.4% slept under an LLIN the previous night, while 38.4% had never used preventive drugs, highlighting substantial gaps between access and utilization. Bivariate analysis showed higher access among caregivers with secondary education, higher income, semi-rural/rural residence, Delta/Rivers residence, and those not admitted in the past year. In multivariate models, reduced access was predicted by hospitalization in the past year (AOR=0.41, 95% CI: 0.30–0.54, p<0.001), while income (10–30k: AOR=1.97; >30k: AOR=3.38, both p<0.001) and semi-urban/rural residence (AOR=2.97 and 2.16, respectively) independently increased access. For utilization, higher income (10–30k: AOR=2.57; >30k: AOR=3.87, p<0.001) and all non-urban residences (semi-urban, semi-rural, rural) significantly increased use.
CONCLUSIONS:
Flood-affected communities in Southern Nigeria show substantial gaps between access to and utilization of malaria preventive interventions for children under-five. Limited access due to flooding strongly constrains utilization, undermining malaria control. Strengthening routine provision, prioritizing poor urban households, and integrating flood-responsive distribution systems are essential to reduce malaria morbidity and mortality.
| eISSN: | 2654-1459 |
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