Malaria remains a leading global public health concern, disproportionately affecting populations in low-resource settings. Uganda continues to contribute substantially to the global malaria burden, yet exposure to malaria-related health messages remains limited. In recent years, diverse media platforms have been adopted to disseminate prevention messages. This study assessed the influence of cumulative exposure to malaria message media channels on knowledge of malaria prevention and its associated factors among women of reproductive age in Uganda. We conducted a secondary analysis of the 2018–2019 Uganda Malaria Indicator Survey (UMIS), comprising 7124 women aged 15–49 years selected using a two-stage cluster and stratified sampling design. Knowledge of four prevention methods recommended by World Health Organization (WHO), bed nets, insecticide-treated nets (ITNs), preventive medicine, and indoor residual spraying (IRS) was assessed. Associations between cumulative media exposure and malaria knowledge were examined using t-tests, margins analysis, and mixed-effects negative binomial regression models. Knowledge of malaria prevention was unevenly distributed: 76.5% of women reported awareness of bed nets, compared with only 9.1% for ITNs, 6.2% for preventive medicine, and 4.3% for IRS. Cumulative exposure to media channels was significantly associated with knowledge of ITNs (p < 0.001), preventive medicine (p = 0.002), and IRS (p < 0.001), but not bed nets. Education, age, wealth, residence, and region were significant determinants of exposure to media channels. Women with secondary or higher education were nearly twice as likely to report exposure to multiple channels compared to uneducated women (Incidence Rate Ratio, IRR = 1.86; 95% Confidence Interval, CI 1.59–2.17). Similarly, women aged ≥ 40 years were 69% more likely (IRR = 1.69; 95% CI 1.35–2.11) to report exposure to multiple channels than those under 20 years. In contrast, rural and refugee women reported significantly lower exposure relative to urban residents (IRR = 0.77 and 0.28, respectively). Cumulative multi-channel exposure to malaria prevention messages significantly improves women’s knowledge of ITNs, preventive medicine, and IRS. However, structural inequities in education, wealth, and place of residence limit access to diverse channels. Integrated, context-specific, and equity-focused communication strategies are essential to broaden awareness beyond bed nets and to accelerate progress toward malaria control and elimination in Uganda.
Natuhamya et al. (Tue,) studied this question.