Date of Conferral



Doctor of Public Health (DrPH)


Health Services


Hadi Danawi


AbstractMalaria is a deadly disease and endemic in Sierra Leone. It is the leading cause of morbidity and mortality amongst children younger than five years in Sierra Leone. Insecticide treated nets (ITNs) are not used widely despite free distribution, low health risks, and proven ability to reduce malaria. The purpose of this quantitative crosssectional study was to investigate the association between a set of independent variables (parental education, parents' economic status, household size, and residence) and the use of ITNs among children under five years of age in Sierra Leone. The study used a secondary dataset from the Ministry of Health and Sanitation, Sierra Leone. The health belief model guided this study. Chi-squared analysis showed that those who resided in rural areas [χ 2 (1) = 53.16, (p = 0.001)], and in the lower wealth index [χ 2 (2) = 52.47, (p = 0.001)] use ITNs more compared with their counterparts. The results of the simple logistic regression revealed that higher economic status (OR 0.28, 95% CI: 0.03 – 2.6, p = 0.001), and living in urban residences (OR 0.28, 95% CI: 0.2 – 0.4, p = 0.001) could predict ITN use. Likewise, controlling for all other factors, multiple logistic regression showed that the wealth index (OR 1.45, 95% CI: 1.1 – 1.9, p = 0.008) and residence (OR 0.41, 95% CI: 0.25 – 0.65, p = 0.001) significantly predicted ITN use among children under five years in Sierra Leone. Wealth index and residence were identified as factors that may affect the use of ITNs as a malaria control measure among children under five years in Sierra Leone. Considering these factors for future mass distribution of ITNs could help achieve the desired malaria prevention goals. This will reduce morbidity and mortality of the children thus bringing about positive social change.