Factors associated with insecticide-treated net utilization among women of reproductive age in Ghana: a cross-sectional study.

backgroundSub-Saharan Africa (SSA) bears the highest malaria burden globally, accounting for 95% of all cases and 96% of malaria-related deaths, with an estimated 593,000 fatalities. Among women of reproductive age, malaria not only impacts their health and survival but also leads to adverse birth outcomes. This study aims to examine the factors influencing the use of insecticide-treated nets (ITNs), the primary method of malaria prevention among this high-risk group in Ghana.

methodsThis study used data publicly available from the 2019 Ghana Malaria Indicator Survey (GMIS). GMIS was originally a cross-sectional study that employed a multi-stage probability sampling technique to select a total of 4114 women between the ages of 15 and 49. A structured interview schedule was used to elicit information on socio-demographic characteristics, ITN ownership, use, knowledge, behavior, and practices. Descriptive statistics and multivariable logistic regression analyses were performed on GMIS data in this study. All tests were two-sided, and statistical significance was set at p < 0.05.

resultsThe study revealed that 79% of women of reproductive age in Ghana had at least one ITN, and 56% of women who owned an ITN used it the previous night. Women with children were more likely to use ITN than those without, with the likelihood increasing with the number of children. Compared to nulliparous women, ITN use was higher among primiparous (aOR 1.65; 95% CI 1.17, 2.32), multiparous (aOR 1.94; 95% CI 1.39, 2.71), and grand multiparous women (aOR 2.06; 95% CI 1.34, 3.18). The odds of ITNs' utilization were lower in women who had three or more ITNs (aOR 0.52; 0.43, 0.63) compared to women who had fewer than three ITNs. Women living in the Brong-Ahafo region (aOR 2.22; 1.42, 3.46) and the Upper West region (aOR 2.59; 1.59, 4.28) had higher odds of ITN utilization compared to women in the Eastern region. All adjusted models controlled for age, education, parity, household wealth, and media exposure.

conclusionAlthough ITN ownership among this key population is promising, utilization remains low. This study highlights the need to consider both individual and community-level factors when designing targeted malaria prevention interventions. Addressing these determinants is essential for ensuring equitable access to ITNs and enhancing their use, ultimately strengthening malaria control efforts in Ghana.