Determinants of Consistent Long-Lasting Insecticidal Net Utilization Among Pregnant Women Attending Antenatal Clinics in Egbeda Local Government Area, Oyo State, Nigeria

Abstract

Background: Malaria remains a major public health challenge in sub-Saharan Africa, with pregnant women among the most vulnerable populations due to the adverse maternal and fetal outcomes associated with infection. Long-lasting insecticidal nets (LLINs) are one of the most effective malaria prevention interventions; however, consistent utilization among pregnant women remains suboptimal in many endemic settings. This study assessed the determinants of consistent LLIN utilization among pregnant women attending antenatal clinics in Egbeda Local Government Area, Oyo State, Nigeria. Methods: A descriptive cross-sectional study was conducted among 400 pregnant women attending selected antenatal clinics in Egbeda Local Government Area. A multistage sampling technique was used to recruit participants. Data were collected using a structured interviewer-administered questionnaire covering socio-demographic characteristics, obstetric history, knowledge of malaria and LLINs, LLIN ownership and utilization, and factors influencing consistent utilization. Data were analysed using IBM SPSS version 26. Descriptive statistics were summarized using frequencies, percentages, means, and standard deviations. Chi-square tests were used to examine associations between independent variables and consistent LLIN utilization, while multivariable logistic regression analysis identified independent predictors. Statistical significance was set at p < 0.05. Results: The mean age of the respondents was 27.25 ± 6.03 years. Most respondents (60.0%) demonstrated good knowledge of malaria and LLINs, while 89.0% owned at least one LLIN. However, only 63.0% reported consistent utilization of LLINs. Health education received during antenatal care, household availability of sufficient LLINs, and the perceived protective benefits of LLINs were major facilitators of consistent utilization, whereas heat discomfort, forgetfulness, and perceived inconvenience were commonly reported barriers. Bivariate analysis showed significant associations between consistent LLIN utilization and age, marital status, educational level, monthly household income, knowledge level, antenatal care attendance, and household availability of sufficient LLINs (p < 0.05). Multivariable logistic regression identified household availability of sufficient LLINs (AOR = 3.84; 95% CI: 2.26–6.53), attendance at four or more antenatal visits (AOR = 3.27; 95% CI: 1.77–6.06), good knowledge of malaria and LLINs (AOR = 2.64; 95% CI: 1.61–4.32), tertiary education (AOR = 2.96; 95% CI: 1.58–5.56), higher monthly household income (AOR = 2.18; 95% CI: 1.36–3.49), and being married (AOR = 1.89; 95% CI: 1.14–3.14) as significant predictors of consistent LLIN utilization. Conclusion: Although LLIN ownership and knowledge of malaria prevention were high among pregnant women, consistent utilization remained below the universal coverage target. Household availability of LLINs, regular antenatal care attendance, educational attainment, household income, and adequate knowledge significantly influenced consistent utilization. Strengthening routine antenatal health education, ensuring adequate household access to LLINs, and implementing targeted behavioural change interventions are essential for improving consistent LLIN utilization and reducing the burden of malaria during pregnancy.