Alma Ata Declaration and malaria prevention: Ten years narrative review of landmark achievement on use of insecticide treated Nets (ITNs) among pregnant mothers and children under five in Nigeria

Alma Ata Declaration and malaria prevention: Ten years narrative review of landmark achievement on use of insecticide treated Nets (ITNs) among pregnant mothers and children under five in Nigeria

Abstract: Malaria epidemiology in Nigeria is still at a concerning rate. Health promotion is fundamental in primary healthcare (PHC) and one of the components is the prevention of endemic diseases, which include the use of insecticide treated nets (ITNs), provided free and Roll Back Malaria (RBM) programs. The objective of this study is to narratively review the ten years landmark achievement of Alma-Ata declaration on the use of ITNs among pregnant mothers and under-five children between 2009 and 2019 in Nigeria, including the RBM target and geopolitical zones' performances.

Methods: This non-systematic review study selected 50 studies on epidemiology on malaria, PHC, health promotion and Alma-Ata declaration on use of ITNs from literature searched. Search bases included Google Scholar, while inclusion were peer reviewed journals and governmental documents.

Results: ITNs ownership and utilization in the geographical zones of Nigeria are unequal since 2010. By 2019, Nigeria household ownership of at least one ITNs was 55%, which is short of the 80% RBM targeted since 10-years ago. Reduction in prevalence of malaria is strongly associated with baseline knowledge of the disease (p < 0.0001); while level of non-utilization of ITNs in 2010 is positively correlated to improvement in ownership in 2019 (p < 0.03).

Conclusion: Achievement of Alma-Ata declaration in the availability of ITNs has yet to reach the RBM target and there is indication of backsliding. There is need to reactivate and sustain health promotion programs on ownership and utilization of ITNs at the community level.