ACHEVI FINAL.docx

KENYA MEDICAL TRAINING COLLEGE MOSORIOT CAMPUS
FACULTY OF NURSING
P.O BOX 30-30307
MOSORIOT.
A RESEARCH PROJECT ON FACTORS AFFECTING UTILIZATION
INSECTICIDE TREATED NETS AMONG WOMEN IN CHEPKUNYUK
VILLAGE, NANDI COUNTY
PRESENTER
ACHEVI FRANCISCAH
MARCH 2018
ADMISSION NO. D/NURS/18047/6220
SUPERVISOR: MR. PATRICK ROTICH
A RESEARCH PROJECT SUBMITTED IN PARTIAL FULFILMENT OF
THE REQUIREMET FOR THE A WARD OF DIPLOMA IN KENYA
REGISTERED COMMUNITY HEALTH NURSING
JANUARY 2022

ii
DECLARATION
I hereby declare that am the author of this original project and that not any party of this project
has ever been submitted to any examination body for an award of academic qualification.
Name: Achevi Franciscah
Signature: …………………………………………. Date: ………………………
Approval
The undersigned certify that they have read and recommended from department of nursing for
acceptance of proposal entitled.
Factors affecting utilization of insecticide treated bed nets among women in Chepkunyuk village,
Nandi County.
Declaration by supervisor:
The research project has been submitted with my/our approval as college tutor/supervisor.
Name: Patrick Rotich
Signature: ………………………………………. Date: ………………………

iii
DEDICATION
I dedicate this study to my beloved parents Mr. and Mrs. Achevi for financial support and moral
support to his project. Thanks to all my family members who gave me humble time to carry out
my research and encouragement.

iv
ACKNOWLEDGMENT
I express my gratitude to the almighty God for the far He has brought me, giving me strength,
health, knowledge and resilience that I so much needed to embark on this project.
I also acknowledge the support of guardians for the unconditional support and encouragement,
this provided the driving force behind my training.
Friends, relatives and schoolmates for the calm environment and any other participation that
made my school life an enjoyable encounter.
Reserved acknowledgement goes to my supervisor Mr. Patrick Rotich for his endless support,
throughout advices and excellent supervision and for having keen interest in every stage of his
work.
Many thanks to all members of Chepkunyuk village community for not only enabling me
complete my project but also gain vast knowledge and skills on insecticide treated bed nets.
May almighty God bless all of you.

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CONTENTS
DECLARATION......................................................................................................................................... ii
DEDICATION............................................................................................................................................ iii
ACKNOWLEDGMENT ........................................................................................................................... iv
ABREVIATIONS...................................................................................................................................... vii
LIST OF TABLES................................................................................................................................... viii
ABSTRACT................................................................................................................................................ ix
CHAPTER ONE .........................................................................................................................................1
BACKGROUND OF THE STUDY...........................................................................................................1
1.1 INTRODUCTION ..............................................................................................................................1
1.2 STATEMENT OF THE PROBLEM ..................................................................................................2
1.3 JUSTIFICATION OF THE STUDY ..................................................................................................3
STUDY OBJECTIVES...............................................................................................................................3
SPECIFIC OJECTIVES ............................................................................................................................3
STUDY QUESTIONS.................................................................................................................................3
HYPOTHESIS.............................................................................................................................................3
CHAPTER TWO ........................................................................................................................................4
2.1 LITERATURE REVIEW ...................................................................................................................4
CHAPTER THREE....................................................................................................................................6
METHODOLOGY .....................................................................................................................................6
3.1 INTRODUCTION ..............................................................................................................................6
3.2 RESEARCH DESIGN........................................................................................................................6
3.4 STUDY AREA ...................................................................................................................................6
3.5 TARGET POPULATON....................................................................................................................6
3.6 SAMPLE SIZE ...................................................................................................................................6
3.7 SAMPLING TECHNIQUE /PROCEDURE ......................................................................................6
3.7.1 DELIMITATION......................................................................................................................7
3.7.2 ASUMPTION ...........................................................................................................................7
3.8 SAMPLING SIZE DETERMINATION.............................................................................................7
3.9 Ethical consideration...........................................................................................................................8
3.10 Limitations........................................................................................................................................8
3.11 DATA COLLECTION .....................................................................................................................8
3.12 DATA ANALYSIS...........................................................................................................................8

vi
3.13 DATA PRESENTATION.................................................................................................................8
CHAPTER FOUR.......................................................................................................................................9
DATA ANALYSIS AND PRESENTATION, INTERPRETATION AND DISCUSSION OF
FINDINGS...................................................................................................................................................9
4.1 INTRODUCTION. .............................................................................................................................9
4.2 RESPONSE RATE. ............................................................................................................................9
4.3 BACKGROUND CHARACTERISTICS OF RESPONDENTS........................................................9
Table 1a below shows the ranges of age....................................................................................................9
Table 2a below shows level of education. ..................................................................................................10
Table 3a showing knowledge on ITN.........................................................................................................11
Table 4a shows importance of ITN use ......................................................................................................12
Factors affecting utilization of ITN among women....................................................................................13
Table below shows those who goes for ANC visits during pregnancy.......................................................14
Improving ITN usage among women in the community. ...........................................................................15
CHAPTER FIVE ......................................................................................................................................16
SUMMARY ...............................................................................................................................................16
5.1 INTRODUCTION ............................................................................................................................16
5.2 CONCLUSIONS...............................................................................................................................17
5.3 RECOMMENDATION ....................................................................................................................17
REFERENCES..........................................................................................................................................18
APPENDIX 1: QUESTIONAIRE............................................................................................................19
APPENDIX 2: BUDGET..........................................................................................................................23
APPENDIX 3: WORK PLAN FROM JANUARY 2021 TO JANUARY 2022 ...................................24
APPENDIX IV: Map Showing Study Area , Chepkunyuk Dispensary...............................................25

vii
ABREVIATIONS
ITNS Insecticide Treated Nets
LLINS Long Lasting Insecticidal Nets
MCP Malaria Control Programme
MOH Ministry of Health
WHO World Health Organization
NGOS None Governmental organizations
WOCBA Women of Childbearing Age
HC Health Care
MIP Malaria In Pregnancy

viii
LIST OF TABLES
Table 1a below shows the ranges of age. ………………………………………………………………………………….9.
Table 2a below shows level of education. ………………………………………..………………………………………10.
Table 3a showing knowledge on ITN ...…………………………………………………………………………………………..11
Table 4a shows importance of ITN use …………………………………………………………………………………………….12.

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ABSTRACT
This study look at factors affecting utilization of insecticide treated nets among women in
Chepkunyuk village, Nandi County. This research was carried out between January 2021 to
January 2022. The researcher followed all the criteria for reaching the respondents by requesting
from the research team head a letter for permission tom approach the chief whereby the chief
accepted the request and granted permission and the respondents were assured of privacy and
confidentiality. The objectives were to establish women knowledge on the utilization of
insecticide treated nets, to determine factors affecting utilization of ITN, to find out the strategies
that can be used to address the current problems. The researcher used 25% of the population as a
sample to present the whole target population. Qualitative descriptive method was used to obtain
answers to the questions being studied on factors affecting utilization of insecticide treated nets
which were; ignorance, employment status, culture, religion. The sampling technique adapted
were accidental or convenient technique. The researcher used questionnaire for data collection,
so people were distributed on the first time first serve and afterwards collected for analysis and
presentation as tables, pie charts.
In conclusion there are problems in ITN utilization in Chepkunyuk village and women are
affected and this is caused by ignorance being the leading. A recommendation was that there
should be an improvement on health messages especially to women on ITN utilization and
government to distribute ITN to women in the village. The community should also be given
health education on ITN utilization and its importance.

1
CHAPTER ONE
BACKGROUND OF THE STUDY
1.1 INTRODUCTION
Insecticide treated bed net is one type of cost effective vector control approach for the prevention
of malaria and it has to be treated with insecticide and need ongoing treatment. It implies that
using ITN is very helpful way in prevention of malaria transmission in highly endemic areas.
Malaria is an infectious disease which can be transmitted from person to person through biting of
female anopheles’ mosquitoes. Malaria remains a preventable cause of serious death and illness
worldwide including Kenya. In 2016, in estimation 216 million cases of malaria occurred
worldwide. From this report, 90% of cases were reported from the African region with 80% of
the reported from sub-Saharan Africa. According to world health organization (WHO) 2017,
there were total of 445,000 deaths due to malaria in 2016 of which 90% of deaths were from the
African region.
Despite malaria affects all ages and sexes, its infection, severity, recurrence, complication and
malaria related death is very common in pregnant women and children less than 5years of age
due to low immunity during pregnancy and under 5 age.
Different analytical studies reveal that infection of malaria during pregnancies has bad pregnancy
outcomes like miscarriages, maternal anemia, still birth, intrauterine growth restriction, low birth
weight, neonatal sepsis and prematurity.
Prematurity and neonatal sepsis are the 1st
and 2nd
leading causes of neonatal mortality as
evidenced by Demographic Health Survey 2014. This indicates that malaria infection during
pregnancy is a major health problem of newborn and mother.
Malaria during pregnancy is the major common problem worldwide and it is the common
indirect cause of maternal mortality. The burden of malaria during pregnancy, including its
complications is high in African countries. With high number of pregnancies which are at risk,
the consequences of malaria is very high for both the mother and the child in terms of morbidity
and mortality. This problem can be eliminated or reduced by appropriate utilization of insecticide
treated nets for all pregnant women. Using appropriate ITNS is considered as a key in reducing
the adverse effects of malaria during pregnancy among the vulnerable populations. The effective
use of effective insecticide treated nets is shown to reduce malaria transmission by 90% and
miscarriages and still birth by 33%. In order to control this high burden of malaria during
pregnancy, the federal ministry of health has distributed 29.6million long lasting insecticide nets
which represent 60% of the total population.
Even if the magnitude of malaria during pregnancy is high and there are different strategies to
decrease the risk of malaria for vulnerable groups, many articles revealed that the use of ITNS by
the pregnant women is very low and this low utilization of IITNS by pregnant women is affected
by education status, occupation, residence, ownership of television or radio, religion, ethnicity,
age and family monthly income.

2
1.2 STATEMENT OF THE PROBLEM
Miscarriages, maternal anemia, still birth, intrauterine growth restriction, low birth weight and
neonatal sepsis and prematurity are commonly the complications related to malarial infection
during pregnancy and this is common to women in Chepkunyuk Nandi County leading to
maternal mortality. Most of the clients attending Kapsabet hospital clinic comes with history of
miscarriages, maternal anemia and also low birth weight babies and this is caused by malaria due
to the problem of not using insecticide treated nets among women who are pregnant.
Most women in Chepkunyuk use the insecticide treated nets to fence their farms instead of using
them to prevent mosquito bites hence leading to malaria. Some does not have knowledge on the
importance of using insecticide treated nets and therefore they do not use them well.

3
1.3 JUSTIFICATION OF THE STUDY
This research is intended to assess whether the pregnant women living in Chepkunyuk have
significant knowledge on utilization of insecticide treated nets in management of malaria. The
study is intended to improve women’s knowledge on better utilization of insecticide treated nets
to promote better management of malaria in pregnant women.
The study will also provide data to show the knowledge of clients and hence enhance better
utilization of insecticide treated nets.
STUDY OBJECTIVES
BROAD OBJECTIVES
1. Study on factors affecting the utilization of insecticide treated nets among women in
Chepkunyuk, Nandi County.
SPECIFIC OJECTIVES
1. To establish women knowledge on utilization of insecticide treated nets.
2. To determine factors affecting utilization of insecticide treated nets among women.
3. To find out common cultural beliefs and practices affecting use of ITNS at Chepkunyuk.
4. To teach women on how to use the insecticide treated nets and importance of insecticide
treated nets.
5. To find out the strategies that can be used to address the current problem.
STUDY QUESTIONS
What are the factors affecting utilization of insecticide treated nets among women?
What are the reasons for not using insecticide treated nets?
What is the community level of knowledge regarding utilization of insecticide treated nets to
women?
What are the complications of ineffective use of insecticide treated nets to pregnant women?
How does culture and beliefs affects knowledge about use of insecticide treated nets?
HYPOTHESIS
Educational status, occupation and age are the leading factors that affects the utilization of
insecticide treated nets among women in Chepkunuk.

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CHAPTER TWO
2.1 LITERATURE REVIEW
Insecticide treated bed net is one type of cost effective vector control approach for the prevention
of malaria and it has to be treated with insecticide and need ongoing treatment.
Use of ITNS is one of the core vector methods for malaria prevention and has been shown to
reduce malaria incidence by 50% in several malaria endemic countries. The effects of malaria
are especially strong among pregnant women for whom malaria may cause maternal anemia,
preterm delivery and low birth weight. High ITN coverage in sub-Saharan Africa has been
reported, however, discrepancies in ITN use in the region remain problematic.
In Malawi, ITN are the Centre of malaria control initiatives. A worldwide mass ITN distribution
campaign took place in 2012. The Malawi ITN policy recommends that free ITN be given to
women and children during antenatal visits (ANC) and expanded Programme on immunization
(EPI) Visits. These efforts led to rise in ITN use among pregnant women from 35% in 2010 to
60% in 2014. However a 2015 Malawian study revealed a drop in ITN use to 55% among
women of childbearing age (WOCBA) who had visited ANC facilities. This drop is a concern in
the fight to eliminate malaria by 2030.
A large body of research has demonstrated that factors such as women’s age, parity, educational
status, employment status, household wealth and religion have significant effects on the
utilization, for instance in Kenya, women who had received a higher level of education were
twice as likely to use ITNS than women with no formal education.
In Cameroon, 45% of multiparous women reported having slept under an ITN the night before
the survey as compared with 21% of primigravida women.
A cross-sectional study was conducted in Raya Zebo district, Ethiopia, to assess utilization of
ITN and its associated factors among pregnant women of the predominantly rural population and
the findings revealed that 22.2% of pregnant women reported sleeping under ITN the night
before the survey.
According to another cross-sectional study which was done in Shahsogo Wereda, Ethiopia,
among pregnant women, 15.8% of participants owned at least one ITN. From those pregnant
women who owned ITN, 7.5% of participants had good practice of ITN utilization.
In Ethiopia nearly about 75% of its total area is malaria’s and about 65% of its population is at
risk of developing malaria infections. Studies indicate that in estimation 25million pregnancies
are at risk of developing malaria in Sub –Saharan Africa every year. With this high number of
pregnancies which are at risk, the consequence of malaria is very high for both the mother and
the child in terms of morbidity and mortality.
In Ethiopia, the prevalence of malaria during pregnancy varies from 6.1% to 10.4% which is a
public health problem. But this terrible problem, can be eliminated or reduced by appropriate
utilization of insecticide treated nets for all pregnant women.

5
Malaria remains a preventable cause of serious death and illness worldwide, including Ethiopia.
In 2016, in estimation 216 million cases of malaria occurred worldwide. From this report, 90%
of cases were reported from the Africa region with 80% of the report from Sub Saharan Africa.
According to WHO 2017, there were total of 445,000 deaths due to malaria in 2016 of which
90% of deaths were from the African region. Despite malaria affects all ages and sexes, its
infection, severity, recurrence, complication and malaria related death is very common in
pregnant women and children less than five years of age due to low immunity during pregnancy
and under 5 age.
Different analytical studies reveal that infection of malaria during pregnancies has bad pregnancy
outcomes like miscarriage, maternal anemia, still birth, intrauterine growth restriction, low birth
weight, neonatal sepsis and prematurity.
Prematurity and neonatal sepsis are the 1st
and 2nd
leading causes of neonatal mortality in
Ethiopia as evidenced by mini- Ethiopia Demographic Health Survey (MEDHS) 2014. This
indicates that malaria infection during pregnancy is a major health problem of newborn and
mother.
Malaria during pregnancy is a major problem worldwide and it is the common indirect cause of
maternal mortality and this problem can be eliminated or reduced by appropriate use of
insecticide treated nets for all pregnant women and proper education to women of all child
bearing age on usage of insecticide treated nets and its importance.
In Kenya, malaria is the leading cause of morbidity and mortality with close to 70% (24million)
of the population. Free distribution of insecticide treated bed nets is preferred to partial of the
price of insecticide treated bed nets on usage and demand in Kenya.
Malaria interventions including universal LLIN coverage, targeted deployment of indoor residual
spraying and prompt diagnosis and treatment have been scaled up in western Kenya since the
early 2000s.
A research has demonstrated that factors such as women’s age, parity, educational status,
employment status, household wealth and religion have significant effects on ITN utilization. In
Kenya, women who had received a higher level of education were twice likely to use ITNs than
women with no formal education.
In Chepkunyuk, the prevalence of malaria during pregnancy is high since women living in
Chepkunyuk are not using ITNs appropriately, yet they use them to fence the gardens instead of
using them to prevent mosquito from biting them. Factors like educational status, employment
status and household wealth have significant effects on ITN utilization among women living in
Chepkuyuk since most of the women are not highly educated and therefore they do not have the
knowledge about ITN use. Malaria during pregnancy is a major problem in Chepkunyuk and it
causes maternal mortality and this problem can be eliminated or reduced by appropriate use of
insecticide treated nets for all pregnant women and proper education to women of all child
bearing age on utilization of insecticide treated nets and how it prevents malaria infection.

6
CHAPTER THREE
METHODOLOGY
3.1 INTRODUCTION
This chapter provides the framework within which data will be collected. It contains the research
design, study area, sample, sampling techniques, data collection, the target population, sample
size, data analysis and data presentation.
3.2 RESEARCH DESIGN
Quantitative descriptive design will be used as a method for obtaining answers to the questions
being studied. It involves measuring data in terms of numbers and it intends to accurately
determine and reports on status of the subjects under study.
Descriptive research is concerned with conditions or relationships that exist, practices that
prevail, processes that are ongoing, attitudes that are held or trends that are developing (best
1970). This study will adopted a survey approach which is present oriented method used on a
population by selecting a sample which is analyzed discovers occurrences. This provides
numeric description of the sampled population which is suitable for extensive study. Descriptive
survey is a method of collecting information by interviewing or administering a questionnaire to
a sample of individuals (Orodho 2003).
3.4 STUDY AREA
The study was conducted at Chepkunyuk village in Nandi County.
3.5 TARGET POPULATON
The target population to be studied are women of child bearing age group between 15 -49 years.
3.6 SAMPLE SIZE
A sample is a set of respondents selected from a larger population for the purpose of the survey.
(Kothari 2004) confirms that a sample size is part of the population that took part in the study. A
sampling frame has the property to identify every single element and include it in the sample. In
this research, the sampling frame to be used will be that of the women of child bearing age
(WOCBA) 15-49Years of population of the Chepkunyuk village in Nandi country.
3.7 SAMPLING TECHNIQUE /PROCEDURE
It entails selecting a number of individuals from the population such that the selected group
contains elements representing the characteristics found in the entire sample. Sample can be
selected by sampling design (Kothari 2014). Random sampling technique will be used to select
the intended respondents as per the required.

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3.7.1 DELIMITATION
The study covered all women of all reproductive age. The study was simple random of sampling
and data was collected using interview schedule, and data collected was analyze using computer
packages.
3.7.2 ASUMPTION
Researcher assumes that answers given by the respondents were correct and questions were
clearly understood.
3.8 SAMPLING SIZE DETERMINATION
If there’s no estimate available of the proportion in the target population assumed to have
characteristics of interest, 50% was used to estimate the sample. Sampling size determination by
fishers et al 1998 method
N=z2
pqld2
that if the population is 710000
Z= Standard normal deviation taken as 1.96 at confidence level of 95%
P= Proportion of target population estimated to have similar characteristics of variable
q = is the proportion of the target population estimated not to have similar
characteristics being measured
d =degree of accuracy desired 0.05
Z= 1.96
P= 0.5
q =0.5
d =0.05
n =1.962
x0.5x0.5
0.052
N=384.16
Since the study population is less than 10,000 I will use the Cochrane’s formula for adjustment
hence: nf = n/i(n/N)
Where nf =sample size
n =sample size to be used
N= total number of population in the site
Therefore:nf =384.16/(1+384.16/137)

8
=384.16/3.804
=100
The desired sample size is 100 women of reproductive age using insecticide treated nets.
3.9 Ethical consideration
Confidentiality was ensured and assured to the respondents verbally by the researcher and
permission to conduct the study was obtained the college principal through head of departments
of Nursing. Participation was voluntary through informed consent.
3.10 Limitations
The study was limited by lack of time in collection of information, communication barrier where
the researcher was forced to interpret the questionnaire himself with the help of the interpreter, it
was expensive in terms of cost and printing materials, another constraints to the study is
accessible of literature related to insecticide treated bed nets as it has not been researched by
many people.
3.11 DATA COLLECTION
Questionnaires was used for collecting data, structured questions (closed ended question) is used
because they are easy to analyze, easy to administer due to alternative answers given and
economical in terms of money and time.
A questionnaire is a number of questions in a document written or typed in a definite order or a
form or set of forms.
3.12 DATA ANALYSIS
Data collected was analyzed to obtain a meaningful and conclusion. This will involve sorting,
coding and entering by tallying the different responses to be able to obtain the frequency of
responses.
3.13 DATA PRESENTATION
The analyzed data was presented by use of pie charts or bar graph. This will enable easy
interpretation of trends of distribution of analyzed data.

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CHAPTER FOUR
DATA ANALYSIS AND PRESENTATION, INTERPRETATION AND DISCUSSION OF
FINDINGS.
4.1 INTRODUCTION.
In this chapter the research done will present the data from the field and data analysis procedures
are employed to answer the research questions that guided the study questions below. What are
the factors that affects ITN utilization among women? What are the ways of improving ITN
usage among women in the community? The data collected was then revisited to access the
contribution of the data to the body of knowledge.
4.2 RESPONSE RATE.
Questionnaire on factors affecting utilization of insecticide treated nets was distributed to
Chepkunyuk village in Nandi County. The questionnaire had 16 questions which were
administered to the respondents in the study area and the questions were well responded to
within two days.
4.3 BACKGROUND CHARACTERISTICS OF RESPONDENTS
The information on the background characteristics of respondents in Chepkunyuk village had
varied background. The research was done as scheduled and found necessary for analyzing the
data collected. It include gender, age, marital status, education level, clinic attendance during
pregnancy, importance of using ITN, seasons when ITNS are used, factors that affects ITN use
among women. The study found it necessary to analyze the respondent’s gender, as there were
need to demonstrate the heterogeneity of the respondents.
1. A) Age
Table 1a below shows the ranges of age.
Age No. of ages No. of percentage
18-20 1 11
20-30 5 56
30 and above 3 33
Total 9 100

10
Figure 2b below shows ranges of age.
Most of the respondents were age bracket of 20-30 years with 56% followed by 30 years and
above with 33% and the least being 18-20 years with 11%. The youths and elders are the most in
the population.
2. A) Level of education
Table 2a below shows level of education.
Level of education No. of people No. of percentage
College/University 5 56
Secondary 2 22
Primary 2 22
Never attended 0 0
Total 9 100
Figure 2b shows the level of education
Most of the respondents had reached college/university level shown by 56% followed by
secondary and primary level with 22% each. Most of the people are learned.
11%
33%
56%
Ages
20-30 years
30 and above years
18-20 years

11
3. Knowledge on ITN
Table 3a showing knowledge on ITN
Respondents No. of respondents No. of percentage
Yes 7 78
No 2 22
Total 9 100
Figure 3b showing knowledge on ITN
College/University
Secondary
Primary
Never attended
LEVEL OF EDUCATION

12
Most of the respondents had knowledge about ITN shown by 78% and those who did not have
knowledge with 22%.
4. Importance of ITN use
Table 4a shows importance of ITN use
Yes 7 78
No 2 22
Total 9 100
Figure 4b showing importance of ITN use
Yes
No
KNOWLEDGE ON ITN

13
Most of the respondents had knowledge of the importance of insecticide treated nets with 78%
and 22% those who with no knowledge.
Factors affecting utilization of ITN among women
Table below shows Factors affecting utilization of ITN among women
Ignorance 7 78
Employment status 21 11
Culture 1 11
Religion 0 0
Total 9 100
Yes
No
IMPORTANCE OF ITN USE

14
Graph below shows factors affecting utilization of ITN among women
Majority of the respondents are ignorant on the ITN utilization with 78% followed by
employment status/culture both with 11% and religion with no effects on the utilization.
5. ANC visits during pregnancy
Table below shows those who goes for ANC visits during pregnancy.
Yes 3 33
No 3 67
Total 9 100
Pie chart showing ANC visits during pregnancy
0
10
20
30
40
50
60
70
80
Ignorance Employment status Culture Religion
factors affect ITN utilization
Ignorance Employment status Culture Religion

15
Most of the respondents, 33%, do not go for ANC visits while the few, 67%, go for ANC visits.
Improving ITN usage among women in the community.
Table showing improving ITN usage among women in the community
Women to attend ANC visits 1 11
Government to distribute ITN
among women
1 11
Improving health messages
especially to women on ITN
use in the community.
7 78
Total 9 100
The most way of improving the usage of ITN use among women is by improving health
messages on ITN use and is shown by 78% followed by women attending ANC visits and
government to distribute ITN among women shown by 11% each.
Health workers in the community are needed to improve on health messages about ITN use
among the women in the community to improve the use of insecticide treated nets among
women.
Yes
No
ANC VISITS

16
CHAPTER FIVE
SUMMARY
5.1 INTRODUCTION
Insecticide treated nets is one type of cost effective vector control approach for the prevention of
malaria and it has to be treated with insecticide and need ongoing treatment. Chepkunyuk village
is affected with malaria due to ignorance on ITN use among the women. This is shown by 78%
of the respondents who are ignorant on the ITN use.
The purpose of the study was to show the factors that affects the ITN utilization which appear to
be on increase although no study has been done to establish this, it is in this regard that I was
prompted to undertake a study to unveil the factors responsible.
The objectives were to identify factors that affects utilization of insecticide treated nets among
women. To establish women knowledge on ITN utilization and to find out the strategies that can
be used to address the current problem.
The hypothesis was that educational status, employment status, ignorance and culture are the
leading factors that affects the utilization of insecticide treated nets among women in
Chepkunyuk village.
The sample size was 100 respondents. 78% of the respondents have experience ignorance as a
major factors that affects the utilization of insecticide treated nets, 11% shows employment
status and 11% culture as other factors that affects the utilization of ITN. The common factor
that affects utilization of ITN among women in Chepkunyuk was ignorance with 78%.
The research found that 78.7 had knowledge about ITN utilization while 22% of the respondents
never had knowledge on ITN utilization.
The researcher established that most women were aged 20-30 years (56%) and most were
married (44%). This means that most of the women who are not married are not using ITNs and
also those who are married included.
From the findings, most of the respondents 67% attends ANS visits and was shown that cost of
women who attended ANC visits in Chepkunyuk village have history of miscarriages, maternal
anemia and also low birth weight babies and this is caused by malaria due to problems of not
using insecticides treated nets among women who are pregnant. Women need to use ITNS to
prevent malaria that may lead to other complications.

17
5.2 CONCLUSIONS
According to discussion the following conclusions have been derived at.
 On assessing knowledge about ITN utilization majority of the respondents 78% have
heard about ITN utilization
 Most of the respondents 56% have reached college/university in educational level, 22%,
secondary,22%, primary level and none of the respondents did never attend school.
 Majority of the respondents 78% knew the importance of IT^N utilization and 22% had
no idea
 Regarding opinion of respondents on how the factors can be improved 78% responded by
improving health messages especially to women attending ANC visits and 11% by
government distributing ITN among women.
5.3 RECOMMENDATION
1. Health care providers should encourage women to practice using ITN at all time
2. Government should introduce programmers that positively advertise ITNS
3. Health care providers to improve on health messages especially to women on ITNS use.
4. Women should attend ANC visits during pregnancy in order to attain knowledge on ITN
using during pregnancy and after birth.
5. Government should distribute more ITNs among women in Chepkunyuk village.
6. Insecticides treated nets need more financial and programmer support from Donors,
NGOs and the international community to ensure that women who could benefit most
have access to it. There is need to develop an advocacy campaign that includes ITNS in
its commodities purchasing plans and fund programmers that effectively introduces and
promote ITN in malaria prevention.

18
REFERENCES
Lengels C. Insecticide-treated nets and curtains for preventing malaria. Cochrane database syst
|Rev.2004. https://lldoi.org/10.1002/14651858.CD000363.pub2.
Desai M, Kuile FO, Nosten F, McGready R, Asamoa K, Brabin B. epidemiology and burden
ofmalaria in pregnancy lancet Infect Dis.2007, 7:93-104
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19
APPENDIX 1: QUESTIONAIRE
Insecticide treated bed nets utilization in Chepkunyuk village is a problem. Cases appear to be on
increase although no study has been done. Women have most affected followed by children and
latest being battering of men. It is in this regard that this study has been planned to establish the
possible factors contributing to this problem with a view to find a solution. This information
gives us paramount for this study to succeed.
INSTRUCTIONS
1. It is not necessary to write your name
2. Kindly respond to all sections in the questionnaire
3. Tick in the appropriate column.
QUESTIONNAIRE TO THE CHEPKUNYUK VILLAGE ON ITN
1. How old are you
A] 18-20years [ ]
B] 20-30years [ ]
C] 30 and above [ ]
2. What is your marital status?
A] Single [ ]
B] Married [ ]
C] Separated [ ]
D] Divorced [ ]
E] Student [ ]
3. What is your level of education?
A] Never attended school [ ]
B] Primary [ ]
C] Secondary [ ]
D] college/university [ ]

20
4. What is your religion?
A] Christian [ ]
B] Muslim [ ]
C] Hindu [ ]
D] Others [ ]
5. What is your occupation?
A] Peasant farmer [ ]
B] Business [ ]
C] Self-employed [ ]
D] Housewife [ ]
E] Student [ ]
6. Do you attend ANC Visits during pregnancy?
A] Yes [ ]
B] No [ ]
7. Do you know about ITN?
A] YES [ ]
B] NO [ ]
8. Were you education on ITN use during ANC Visits?
A] Yes [ ]
B] No [ ]
9. Do you think using ITN is important?
A] Yes [ ]
B] No [ ]
10. If yes, why?

21
A] Help to prevent mosquito bite [ ]
B] Protects from other insects [ ]
C] Help to prevent other sickness [ ]
D] None of the above [ ]
11. If no, why?
A] They cause suffocation [ ]
B] They cause body [ ]
C] They are costly [ ]
12. Is there system of health education for the women on ITN use?
A] Yes [ ]
B] No [ ]
13. If yes, who gives the education?
A] Health workers [ ]
B] Community workers [ ]
C] Teacher [ ]
D] Others [ ]
14. During which season do you use ITN?
A] Rainy [ ]
B] Sunny [ ]
C] Cold [ ]
D] All the time [ ]
E] None of the above [ ]
15. Which of the following factors do you think have effects on ITN utilization among
women?
A] Ignorance [ ]
B] Employment status [ ]
C] Culture [ ]
D] Religion [ ]

22
16. What do you think can be done to improve the usage of ITN among women in the
community?
A] Women to attend ANC visits [ ]
B] The government to distribute ITN among women [ ]
C] Improving health messages especially to women on ITN use in community [ ]

23
APPENDIX 2: BUDGET
ITEM/ACTIVITY QUANTITY UNIT PER KSH AMOUNT IN KSH
2gb Flash drive 1 1000 1000
Ball pens 15 10 150
Pencils 4 20 80
Printing papers 3 reams 400 1200
Rubber 2 10 20
Ruler 1 30 30
Internet services 30 days 120 per day 600
Typing services 50 pages 30 per page 1500
Printing services 50 pages 10 per page 500
Proposal photocopy 50 pages 2 per page 100
Proposal binding 3 copies 50 per copy 150
Questionnaire typing 3 copies 30 per page 90
Questionnaire printing 3 copies 10 per page 30
Questionnaire photocopy 10 copies 6 per page 60
Total 5,510

24
APPENDIX 3: WORK PLAN FROM JANUARY 2021 TO JANUARY 2022
MONTH AUGUST
2021
SEPT
2021
OCT
2021
NOV
2021
DEC
2021
JAN
2022
NO ACTIVITY
1 Identification of
research topic
2 Writing of chapter
1
3 Chapter 2
4 Chapter 3
5 Chapter 4
6 Chapter 5
7 Typing, printing
and binding
8 Handing over

25
APPENDIX IV: Map Showing Study Area , Chepkunyuk
Dispensary

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