Assessment of Insecticide-Treated Nets Coverage and Utilization for Malaria Control Among High-Risk Groups in Mettu Woreda , South West Ethiopia
Dagim Dagne
ABSTRACT
Background: Malaria remains a major public health challenge in Ethiopia, particularly in areas of unstable transmission such as Mettu woreda Insecticidetreated nets (ITNs) are among the most effective and affordable malaria prevention tools. However, gaps between ITN ownership and proper utilization persist. This study assessed the coverage and utilization of ITNs among high-risk groups, specifically children under five years of age and pregnant women, in Mettu woreda, south west, Ethiopia.
Methods: A community-based cross-sectional study was conducted in 2014 among 384 systematically selected households. Data were collected through structured interviews and direct observation using a pre-tested questionnaire. Descriptive statistics summarized ITN ownership and utilization. Logistic regression was applied to identify factors associated with ITN use. Statistical significance was declared at p < 0.05.
Results: Among 828 households surveyed, 310 (80.7%) owned at least one ITN, but only 57.2% reported regular use by all household members. ITN utilization among children under five and pregnant women was 72.9% and 57.3%, respectively. The main barriers to consistent use were discomfort from heat (32.8%), perceived absence of mosquitoes (26.5%), and difficulties in hanging nets properly. Multivariate analysis showed that respondents with secondary education or higher were 2.8 times more likely to use ITNs correctly (AOR = 2.8, 95% CI: 1.6–4.9), and those knowledgeable about malaria transmission were 3.4 times more likely to ensure consistent use (AOR = 3.4, 95% CI: 2.1–5.7).
Conclusions: Although ITN ownership in Mettu woreda is relatively high, utilization among high-risk groups remains below national and global targets. Strengthened behavioral change communication, community sensitization, and continuous monitoring of ITN use are essential to close the gap between ownership and utilization and to sustain malaria control efforts in endemic areas.
