What do women in the highest malaria burden country know about ways to prevent malaria? A multi-level analysis of the 2021 Nigeria Malaria Indicator Survey data.

Background: With Nigeria accounting for 31% of the estimated 608,000 deaths due to malaria globally, good knowledge of malaria prevention is essential for effective malaria control. The objective of this study was to examine the knowledge of malaria prevention and its associated factors among Nigerian women.

Methods: This study analysed secondary data from the 2021 Nigeria Malaria Indicator Survey. The sample included 14,476 women of reproductive age (15-49 years). A multilevel multivariable logistic regression was used to examine individual, household, and community-level factors associated with having good knowledge of malaria prevention.

Results: The weighted prevalence of having good knowledge of malaria prevention was 43.5% (95%CI: 41.7-45.2%). Women with secondary/higher education had 2.35 higher odds of good knowledge of malaria prevention, when compared with those with no formal/primary education (aOR = 2.35; 95% CI: 2.00-2.75). Those exposed to malaria messages had 2.62 higher odds of good knowledge of malaria prevention, when compared with no exposure to malaria messages (aOR = 2.62; 95% CI: 2.31-2.97). Women from non-poor households had 1.42 higher odds of good knowledge of malaria prevention, when compared with those from poor households (aOR = 1.42; 95% CI: 1.17-1.71). Rural dwellers had 39.0% reduction in the odds of good knowledge of malaria prevention, when compared with their urban counterparts (aOR = 0.61; 95% CI: 0.46-0.80). In addition, women from communities with high level of education (aOR = 2.24; 95%CI: 1.38-3.64), moderately exposed to malaria messages (aOR = 1.43; 95%CI: 1.08-1.88) and highly exposed to malaria messages (aOR = 1.71; 95%CI: 1.27-2.30), had higher odds of good knowledge of malaria prevention, when compared with women from communities with low education and low exposure to malaria messages, respectively.

Conclusion: The knowledge of malaria prevention was found to be low. The study identified education, religion, exposure to malaria messages, wealth, region, place of residence, community-level poverty, education and exposure to malaria messages as factors associated with the knowledge of malaria prevention. Addressing these factors through targeted interventions, such as improving educational opportunities for women and enhancing media-driven public health campaigns are essential to enhancing malaria knowledge among this critical demographic group.