Assessment of Socio-Demographic factors associated with the Utilization of Insecticide-Treated Nets (ITNs) Among Children Under-5 years old and Pregnant Women in Nigeria: A secondary analysis of NMIS data

Malaria remains a persistent global health challenge, particularly in sub-Saharan Africa, with Nigeria shouldering a disproportionate burden. Despite extensive interventions, insecticide-treated nets (ITNs) have emerged as a cost-effective tool in the World Health Organizations malaria control strategy. Utilizing data from the 2021 Nigeria Malaria Indicator Survey, this study explores socio-demographic determinants influencing ITN utilization among specific cohorts--children under-5 years and pregnant women. Findings indicate that 56% of Nigerian households possessed at least one ITN, with significant utilization observed among rural households, households from the North West and North East geopolitical zones, and households in the second and lowest wealth quintiles (p <0.05). Only 41.2% of children under-5 years old slept under an ITN on the night before the survey, underscoring notable coverage gaps. Statistical analyses reveal significant associations (p < 0.05) between ITN usage and variables such as age, residence, geopolitical zone, and wealth quintile at both bivariate and multivariate analytical levels. ITN usage decreases with increasing child age and household wealth quintile. For pregnant women, almost half (50%) in all households slept under an ITN the night before the survey. At both bivariate and multivariate analytical levels, significant associations (p < 0.05) were observed between ITN usage among pregnant women and variables such as geopolitical zone and household wealth quintile. Additionally, at the multivariate level, ITN utilization decreases with increasing educational level. Our study reveals the dynamic nature of ITN usage patterns, necessitating ongoing monitoring and adaptive strategies to address regional and socioeconomic differentials, while sustaining awareness initiatives to meet the targets set by the Nigeria National Malaria Strategic Plan.