Assessment of Insecticide-Treated Nets Coverage and Utilization for Malaria Control Among High-Risk Groups in Mettu Woreda,South West Ethiopia

Abstract

Malaria remains a major public health challenge in southwestern Ethiopia, disproportionately affecting vulnerable populations. This community-based cross-sectional study assessed the coverage and utilization of insecticide-treated nets (ITNs) among high-risk groups, specifically pregnant women and children under five years of age, in Mettu Woreda, South West Ethiopia. A multi-stage sampling technique was employed to select 422 households with high-risk individuals. Data were collected using a pre-tested structured questionnaire and observational checklists, and analyzed using descriptive and logistic regression methods. The findings revealed that while household ITN ownership (coverage) was relatively high at 82.4%, the actual utilization rate among the high-risk individuals during the night preceding the survey was significantly lower at 58.7%. Predictors significantly associated with ITN utilization included health education exposure (AOR = 2.4, 95% CI: 1.5–3.8), primary education level of the household head (AOR = 1.9, 95% CI: 1.1–3.3), and family size of less than five members (AOR = 2.1, 95% CI: 1.3–3.5). The study concludes that a substantial gap exists between ITN ownership and actual utilization among high-risk groups in the study area. To maximize the impact of malaria control programs, local health sectors should shift focus from mere distribution to intensive behavioral change communication (BCC) strategies targeting consistent net usage.