Insecticide-treated bed net utilization and its determinants among pregnant women in Dembecha District, Northwest Ethiopia

Abstract Background Insecticide-treated nets (ITNs) are widely used and proven effective in preventing and controlling malaria. However, their utilization varies among households, which can significantly impact the benefits of insecticide-treated nets. This study aimed to assess the household utilization of ITNs and the associated factors among pregnant women. Methods A community-based cross-sectional study was conducted from April to May 2024, including 415 randomly selected pregnant women. Data collection employed a pretested questionnaire, and logistic regression analysis was utilized to identify factors influencing insecticide-treated net (ITN) usage. Variables with a p-value < 0.25 in the univariable logistic regression were considered as candidate variables for inclusion in the multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed, and statistical significance was set at p ≤ 0.05. The model’s performance was assessed using the Hosmer–Lemeshow goodness-of-fit test. Results The utilization of insecticide-treated bed nets among pregnant women was 46.5% (95% CI: 41.7–51.3%). Pregnant women without formal education (AOR = 0.48; 95% CI: 0.28–0.81), monthly income (AOR = 0.98; 95% CI: 0.44–1.97), pregnant women with a family size of less than five (AOR = 2.53; 95% CI: 1.61–3.87), and pregnant women who attended at least one antenatal care (ANC) visit (AOR = 2.08; 95% CI: 1.21–2.58) were significantly associated with insecticide-treated bed net utilization. Conclusion Utilization of insecticide-treated bed nets by pregnant women was 46.5%, which was lower than the WHO recommendation (80%). Insecticide-treated bed nets utilization was significantly associated with education, monthly income, antenatal care (ANC) attendance, and family size. Targeted interventions in Dembecha District should include community training by health extension workers, strengthened household-level bed net supervision, and culturally tailored awareness campaigns via local media and health professionals.