The predictors of ownership and utilization of Long-Lasting Insecticidal Nets among caregivers of under-five children in Ekiti State, South-West, Nigeria

Background - Malaria is a life-threatening disease associated with a high level of morbidity and mortality in sub-Saharan Africa especially among children under five years of age. Long-lasting insecticidal Nets (LLINs) ownership and utilization are some of the proven interventions to reduce the burden of the disease. This paper aims to assess and compare the predictors of ownership and utilization of LLINs among caregivers of under-five children living in urban and rural settlements in Ekiti State, Nigeria. - This was a cross- sectional comparative study among 800 under-five caregivers. A multistage sampling technique selected 400 caregivers each from urban and rural settlements. Data were analyzed using Statistical Product and Service Solution (SPSS) IBM version 23. Univariate analysis was conducted to summarize the data and inferential statistics were generated using chisquare and binary logistic regression at 95%CI. The results showed much lower ownership rates in urban (32.3%) than the rural (33.0%). The predictor of ownership of LLINs among respondents in urban settlements was, obtaining their information about LLINs from health workers, friends as sources of information, awareness, good knowledge, and having positive attitudes about LLINs. Utilization is better in the rural (78.0%) compared to the urban (61.2%). The predictor of utilization of LLINs in urban settlements was having positive attitudes towards LLINs while the predictors of the utilization of LLINs in rural were the number of under-five children with caregivers and positive attitude to LLINs. Conclusion –Ownership of LLINs in both settlements was very low and lagged in urban. The utilization was however higher but also lagged in urban. However, it has not reached the 80% proposed by the National Malaria Control Programme. It is therefore recommended that the Government and partners sustain the free distribution of LLINs throughout the year in the communities to improve ownership and Social and Behavioral Change Communication (SBCC) intervention is necessary to improve utilization.