Abstract:
ackground: Malaria during pregnancy and childhood is one of the major public health challenges globally. Its prevalence is huge in Africa, especially in sub-Saharan countries and Ethiopia. Insecticide-treated mosquito net (ITN) use
is one of the primary malaria preventive strategies. Previous studies did not adequately address the health belief and
behaviour-related correlates of ITN using health belief model (HBM), although a number of studies were conducted
in this theme. Therefore, this study was aimed at assessing the prevalence and associated factors of ITN utilization
among pregnant women and under five children in east Belessa district, northwest Ethiopia, 2020.
Methods: A community-based cross-sectional mixed study was conducted in east Belessa district from February
01–30/2020. A total of 724 eligible participants were included in the quantitative study. A multistage cluster sampling
technique was used. The quantitative data were collected using an interviewer-administered structured questionnaire. Data were entered into Epi data version 4.6.0.2 and then exported to SPSS version 16 for analysis. The binary
logistic regression model was fitted and the level of significance was declared based on AOR with its 95% CI and
p-value≤0.05. Meanwhile, the qualitative data were collected using focus group discussions and key informant interviews, and analysed using a thematic analysis approach.
Results: The prevalence of ITN utilization was 56.5% (95% CI 53.0, 60.2) and independently predicted by a corrugated
iron roof of the house (AOR=1.53; 95% CI 1.15, 2.22), rural residence (AOR=1.59; 95% CI 1.11,2.28),≥2 number of
rooms in the house (AOR=1.56; 95% CI 1.06, 2.30) and high level of perceived barrier (AOR=0.53; 95% CI 0.38,0.74). In
the qualitative findings, the main barrier was connected to misconceptions and misperception towards malaria and
ITN.
Conclusion: The prevalence of ITN utilization in the study area was lower than the national target (100%). It was
significantly associated with household characteristics, residence, and level of a perceived barrier. Reversing th
