Background: Malaria prevention programmes should be based in part on knowledge of why some individuals use bednets while others do not. This paper identifies factors and characteristics
women that affect bednet use among their children less than five years of age in Ghana.Methods: Data come from the baseline component of an evaluation of Freedom from Hunger'smalaria curriculum. A quasi-experimental design was used to select clients (n = 516) of Credit withEducation (an integrated package of microfinance and health education) and non-clients (n = 535).Chi-squares, Fisher's Exact tests and logistic regression were used to compare the characteristicsof mothers whose children use bednets (doers) with those whose children do not (non-doers) andto identify factors associated with bednet use among childrenless than five years of age.Results: The following factors were most closely associated with bednet use: region of residence;greater food security; and caregivers' beliefs about symptoms, causation and groups mostvulnerable to malaria. Most respondents knew mosquitoes caused malaria; however, 20.6% ofdoers and 12.3% of non-doers (p = .0228) thought overworking oneself caused malaria. Ninetypercent of doers and 77.0% of non-doers felt that sleeping under a net was protective againstmalaria (p = .0040). In addition, 16.5% of doers and 7.5% of non-doers (p = .0025) identified adultmales as most vulnerable to malaria.Conclusion: Greater knowledge about malaria does not always translate into improved bednetuse. Though culturally-based ideas about malaria may vary between communities, integrating themintotraditional health education messages may enhance the effectiveness of public health effort.