Determinants of Long-Lasting Insecticide-Treated Bed Net Utilization Among Pregnant Women in Gechi District, Buno Bedele Zone South West Ethiopia: A Community-Based Cross-Sectional Study.

Abstract

Background: Long-lasting insecticide-treated bed nets (LLITNs) are a key malaria prevention method, but their consistent use in Ethiopia, particularly among rural mothers, remains challenging. Information on LLITN usage among pregnant women in resource-limited settings is especially scarce. This study investigated LLITN utilization and the factors influencing its use among pregnant women in the Gechi district, Southwest Ethiopia, in 2024.

Methods: A community-based cross-sectional study was conducted from June to July 2024, including 422 randomly selected pregnant women. Data collection employed a pretested questionnaire, and logistic regression analysis was utilized to identify factors influencing LLITN usage. Variables with a P-value < .25 in univariable analysis were incorporated into the multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed, and statistical significance was set at P ⩽ .05. The model's performance was assessed using the Hosmer-Lemeshow goodness-of-fit test.

Results: The finding of this study revealed that 93.9% of the respondents had LLITN, and the current utilization status of pregnant women was 46.5% [41.7%-51.3%]. The low level of utilization was significantly associated with women' education, parity, antenatal care (ANC) attendance, and family size. Accordingly, women without formal education were 52% less likely [AOR: 0.48, 95% CI: 0.28-0.81]; those with primipara were 1.98 times more likely [AOR: 1.98, 95% CI: 1.30-3.03]; a family size of less than 5 was 2.53 times [AOR: 2.53, 95% CI: 1.61-3.87] more likely, and women who attended at least 1 ANC visit were 2.08 times more likely [AOR: 2.08, 95% CI: 1.21-2.58] to use LLITN.

Conclusion: The pregnant women's LITN utilization in settings was low, associated with women's education, parity, antenatal care attendance, and family size. Key players should focus on awareness creation and ANC follow-up to reduce illness during pregnancy, particularly in rural, hard-to-reach settings.