Prevalence and determinants of insecticide-treated bed-net utilization among under-five children in Ethiopia: a systematic review and meta-analysis

This systematic review and meta-analysis found that nearly half of Ethiopian children under five are not utilizing ITNs, leaving them vulnerable to preventable malaria infection. While factors such as caregiver knowledge, household income, rural residence, sleeping space availability, positive perceptions of ITNs, and media access were significantly associated with ITN use, the substantial heterogeneity among studies underscores the need for context-specific interventions. To improve ITN coverage and consistent use, targeted public health strategies should prioritize addressing socio-economic disparities, enhancing community education, and strengthening ITN distribution systems. These findings support the development of evidence-informed policies and behaviour change interventions, particularly in underserved rural and low-income communities.