The predictors of insecticide-treated bed net utilization among female insecticide-treated bed net owners in Tanzania : A cross-sectional study base on data from the Tanzania Demographic and Health Survey and Malaria Indicator Survey of 2015-2016

Background: Insecticide-treated bed nets (ITNs) are the main component in combating malaria in Tanzania, yet even though women report having access to a ITN, many do not utilize them. This study tries to measure known predictors of utilization and evaluate their impact on utilization among women who have access to a ITN. Methods: All women, aged 14-49, whom had access to ITNs the night before the Tanzania DHS-MIS 2015-2016 were included. Socio-demographic predictors, exposure to media messages against malaria, knowledge and attitude towards using ITNs were tested against self-reported utilization in a logistic regression analysis. Results: Utilization of ITNs was 76.6% and 91.3% of participants knew that ITNs protect against malaria. The richest participants were the most likely to utilize their ITNs compared to the poorest (AOR1 2.46, 2.04-2.96 95% CI). Utilization increased with knowing ITNs protect against malaria (AOR1 1.33, 1.11-1.58 95% CI), being exposed to the ongoing behaviour communication change campaign (BCC) (AOR1 1.26, 1.09-1.47 95% CI), and living in one of the zones that recently had ITNs distributed. Risk factors were being among the youngest or the oldest adults, thinking that it is not important to sleep under ITNs and living in a zone that has not had a recent ITN distribution campaign. Conclusion: Utilizing ITNs increases with knowledge and exposure to the BCC campaign. The poorest are the least likely to utilize their ITNs. More studies are needed as to why ITNs are not used even though women know the benefits of their use