Patterns and correlates of ownership and utilization of insecticide-treated bed-nets for malaria control among women of reproductive age (15-49 years) in Malawi

Malaria is a major public health concern in Malawi. This study explored the patterns and correlates of ownership and utilization of ITNs for malaria control among women of reproductive age in Malawi. Data were derived from the multi-stage cross-sectional Malaria Indicator Survey (MIS) conducted in 2017, which followed ITN distribution in 2012 and 2015. Of the 3860 sampled women aged 15-49 years, 88% (3398/3860) and 64% (2473/3860) reported that they owned and utilized ITNs, respectively. Adjusted multivariate logistic regression analysis showed that the odds of ownership of ITNs were significantly low among women with no education (AOR = 0.36, CI = 0.18-0.72), those with primary education (AOR = 0.50, CI = 0.27-0.94) and poor women (AOR = 0.70, CI = 0.51-0.97). Similarly, the odds of utilization of ITNs were significantly low among women with no education, (AOR = 0.40, CI = 0.26-0.63), primary education (AOR = 0.53, CI = 0.36-0.78) and poor women (AOR = 0.70, CI = 0.51-0.97). Furthermore, the odds of utilization of ITNs were significantly low among women living in households without a radio (AOR = 0.79, CI = 0.67-0.93) and those who have not seen or heard a malaria message in the last 6 months (AOR = 0.74, CI = 0.64-0.87). In order to prevent malaria morbidity and mortality among women of reproductive age, especially those from poor households, the Malawi government and relevant stakeholders need to continue the free distribution of ITNs to the poor and encourage social behaviours that promote the ownership and utilization of ITNs.