Factors Associated With Insecticide-Treated Bed Net Possession and Utilization in Malaria Prevention Among Fulani Pregnant Women in the Savannah Hinterlands of Ghana: A Cross-Sectional Study.

BACKGROUND AND AIM: Malaria poses a major threat to pregnant women in Ghana, especially among marginalized nomadic Fulani communities. This study examined factors influencing insecticide-treated net (ITN) ownership and use among Fulani pregnant women in northern Ghana.

METHODS

A cross-sectional survey was carried out between April and June 2022 among Fulani pregnant women in the West Gonja Municipality. Recruitment combined a limited community census with peer-assisted snowball sampling to capture this mobile population. Data were collected through structured, face-to-face interviews in local languages after obtaining informed consent. Multivariable binary logistic regression was applied to identify factors associated with ITN ownership and, among owners, predictors of utilization. Statistical significance was set at p ≤ 0.05.

RESULTS

Of 159 participants, 54.7% (n = 87) reported owning an ITN. Among owners, usage was 52.9% (n = 46/87). Predictors of ITN ownership included awareness that ITNs prevent malaria ([adjusted odds ratio, AOR] = 3.45, 95% [confidence interval, CI]: 1.33-8.94), prior counseling on ITN use (AOR = 4.52, 95% CI: 1.53-13.34), and lower wealth status (AOR = 0.21, 95% CI: 0.09-0.49). Utilization was linked to knowledge of malaria symptoms (AOR = 0.18, 95% CI: 0.05-0.64), having more than three children (AOR = 0.02, 95% CI: 0.002-0.12), and owning multiple ITNs (AOR = 0.07, 95% CI: 0.02-0.28).

CONCLUSIONS

ITN ownership and use among Fulani pregnant women were far below national and global targets. Possession did not translate into consistent use. Strengthened health education and tailored, mobile-responsive distribution strategies are essential to improve malaria prevention in this underserved population.