SOCIOECONOMIC DIFFERENTIALS IN CHILDHOOD MALARIA PREVALENCE AMONG CHILDREN OF CIVIL SERVANTS AND MARKET WOMEN IN IBADAN-NORTH LOCAL GOVERNMENT AREA

Abstract

Studies on malaria among under-five children in Nigeria have focused largely on preventive behaviours and healthcare providers' knowledge of treatment regimen. They were motivated by concerns about the impact of poverty and lack of awareness on aggregate under-five mortality statistics. However, negligible attention has been paid to health condition among children of the middle class and the rich and the fact that there could be differentials in mortality across socioeconomic status. This study therefore was carried out to examine under-five malaria between two socioeconomically distinct groups that included market women and civil servants in Ibadan North Local Government Area (LGA). The study employed comparative cross-sectional survey design using quantitative data collection technique. A total of 410 respondents were selected for interview through a multistage purposive sampling method, beginning with the selection of Ibadan North LGA which hosts the State Secretariat, Agodi, three markets, the University of Ibadan and a numerous banking institutions. While 202 respondents were selected at the Secretariat which has 17 ministries, 208 respondents were chosen from the Bodija market, which is the largest of all the markets in the LGA. In each of the sites, women that had at least one under-five child at the time of the study and consented to participate in the research were sampled. Data were analysed using descriptive statistics, Chisquare and Logistic Regression. The level of significance was set at 5%. Most of the respondents (53.2 %) had tertiary schools education; 69% of them were between 25 and 36 years and 96% either had and/or catered for between one and two under-five children. The majority of the respondents (99%) heard about malaria from health facilities. On knowledge, 67.6% strongly agreed that mosquito bites cause malaria, 43% identified non-use of ITN, 50% stated that the disease can lead to death if not treated, 52% and 51 % correctly identified its symptoms and stated that prompt treatment could prevent deaths respectively. Knowledge score of respondents, measured by some indices, indicated that 94% had good knowledge of childhood malaria, out of which 66% disposed their refuse inappropriately to indicate disparity between knowledge and action. Respondents' level of wealth (x2 = 4.628, df = 2, p<.099), level of education (x2= 5.708, df = 4, p< 0.222), type of occupation (x2= 2.319, df = 1, p< 0. 128), and age (x2= 4.758, df= 4, p< 0.313) did not have statistically significant association with knowledge of malaria in under-five children. While level of education (x2= 152.110, df = 4, p< 0.001 ), drugs most often used for initial treatment (x2= 79.295, df= 4, p< .001) and ever-used ACT for treatment (x2= 36.642, df= 2, p< 0.001) were significantly associated with respondents' occupation, facility accessed on detection of symptoms was not (x2= 8.365, df= 5, p< 0.137). Odds Ratio (OR) shows that respondents of middle and rich classes were almost 4 and 2 times respectively more likely to have knowledge of malaria than to the poor; civil servants were 1/0.034 (29.4 12) times less likely than traders to have ever-used ACT on their children for treatment of malaria, with Confidence Interval of 0.472-0.289. In this study parents' knowledge of malaria was not a sufficient condition for low prevalence given the discrepancy between knowledge of under-five malaria and actions taken. Socioeconomic status did not necessarily influence positive attitude and behaviour towards childhood malaria. Reorientation should therefore target parents since malaria is pervasive in all households.