Rural Africans Least Likely to Have Malaria Protection

by Bob Tortora, Regional Research Director for Sub-Saharan Africa

One-fourth of rural residents have bed nets, versus one-third of urban dwellers


PRINCETON, NJ -- In Africa, a child dies of malaria every 30 seconds. Yet, according to Gallup World Poll data, just 25% of respondents in sub-Saharan Africa report their household owns at least one bed net -- which effectively prevents infection with the mosquito-transmitted disease.

Because sub-Saharan Africa is largely rural, it's important to consider how this figure breaks down according to whether the respondent resides in an urban or rural community. Those who live in rural regions are less likely than urban dwellers to have at least one bed net in their home, 24% versus 32%, respectively.

A majority of rural households in Mozambique (57%) and Mali (56%) have at least one bed net, while rural residents in Nigeria (9%), Botswana (12%), Ethiopia (12%), and Zimbabwe (13%) are much less likely to own at least one bed net. Urban residents in Botswana (6%), Ethiopia (11%)*, Sierra Leone (11%), Ghana (16%), and Nigeria (16%) are least likely to have at least one bed net in their households.

Why the differences? There are many obstacles to widespread distribution of bed nets throughout the 18 countries in which polling was conducted. Cost is one -- even though almost 20 African countries have reduced or eliminated taxes on bed nets to make them more affordable. Cultural barriers -- such as rumors and superstitions -- are another. Villagers in Kenya, for example, recently returned bed nets by the hundreds because of rumors that the nets "talked to people at night" and were harmful to children.

But the primary problem may be one of simple accessibility. Sub-Saharan Africa's population is mostly rural, with more than 7 in 10 households in the surveyed countries located outside of urban areas**. Access to remote populations is hampered by the transportation infrastructure in many of these countries. In many areas, residents must travel more than 30 minutes just to reach an all-terrain road. Obviously, among urban dwellers this is far less likely to be a problem. Across the 18 countries studied, just 2% of urban residents say they must travel more than half an hour to arrive at an all-terrain road, compared with 21% of the larger population of rural residents.

Survey Methods

Results are based on face-to-face interviews with randomly selected national samples of approximately 1,000 adults, aged 15 and older, who live permanently in the 18 African nations surveyed. For results based on these samples, one can say with 95% confidence that the maximum error attributable to sampling and other random effects is ±3 percentage points. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

*Addis Abba, Ethiopia's largest city, is approximately 2,600m above sea level -- too high to have a climate in which malaria-carrying mosquitoes thrive.

**Based on the two rural sampling strata, towns with 10,000 to 49,999 population and towns/rural villages under 10,000 population, 71.2% of the households in these 18 countries are in rural areas.

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