Utilization of Long-Lasting Insecticidal Nets and Associated Factors Among Mothers Who Have Under-Five Children in Dodota District, Southeast Ethiopia, 2025

Abstract

Abstract Introduction: Long-Lasting Insecticidal Nets (LLINs) are crucial for malaria prevention, particularly for children under five, who face the highest mortality rates in sub-Saharan Africa, including Ethiopia. However, there is insufficient information on maternal health service-related factors influence LLIN utilization among mothers with children under five years in Ethiopia. Objectives: To assess utilization of long-lasting insecticidal nets and associated factors among mothers who have under-five children in Dodota district, Southeast Ethiopia, 2025. Methods: A community-based cross-sectional study was conducted from October 1 to 30, 2025, among 605 randomly selected mothers of children under five in Dodota District, and was supplemented with qualitative data for in-depth investigation. A multistage sampling technique was employed to recruit the study participants. Data were collected through face-to-face interviews by using kobo toolbox and exported to SPSS software version 27 for analysis. Descriptive statistics and binary logistic regression were computed. Variables with P-value less than 0.25 in bivariate analysis were entered into a multivariate analysis. An adjusted odds ratio with a 95% confidence interval was used to measure the strength of the association and statistical significance was declared with a p-value less than 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data. Results: Utilization of LLIN among mothers of children under five years was 58.7% (95% CI: 54.7–62.6). Maternal age ≥45 years (AOR = 2.91, 95% CI: 1.09–7.69), having a family size of four or fewer members (AOR = 2.54, 95% CI: 1.67–3.85), good knowledge of LLIN use (AOR = 1.83, 95% CI: 1.24–2.72), and receiving counseling on LLIN use during antenatal care (AOR = 2.37, 95% CI: 1.49–3.75) were significantly associated with LLIN utilization. Moreover, misbeliefs, misconceptions, use the LLIN for other purposes and insufficient accessibility were the most commonly identified barriers by the qualitative data. Conclusion and recommendation: Utilization of LLINs among mothers of children under five years was below the national target. Maternal age, family size, knowledge of ITNs, and receipt of counseling on LLIN use during antenatal care were significant factors associated with LLIN utilization. Strengthening awareness creation sessions by health care providers on LLIN utilization for under-five children is recommended. Keywords: Utilization, Long-last insect nets, associated factor, under five children, Ethiopia