Malaria Journal (Aug 2023)

Insecticide-treated bed net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

  • Gizachew Ambaw Kassie,
  • Getachew Asmare Adella,
  • Amanuel Yosef Gebrekidan,
  • Natnael Atnafu Gebeyehu,
  • Molalegn Mesele Gesese,
  • Endeshaw Chekol Abebe,
  • Misganaw Asmamaw Mengstie,
  • Mohammed Abdu Seid,
  • Kirubel Dagnaw Tegegne,
  • Sefineh Fenta Feleke,
  • Tadesse Asmamaw Dejenie,
  • Berihun Bantie,
  • Natnael Moges,
  • Yenealem Solomon Kebede,
  • Melkamu Aderajew Zemene,
  • Anteneh Mengist Dessie,
  • Denekew Tenaw Anley,
  • Yordanos Sisay Asgedom

DOI
https://doi.org/10.1186/s12936-023-04655-7
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 17

Abstract

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Abstract Background Malaria infection during pregnancy endangers the pregnant woman, fetus, and newborn child. Thus, the use of an insecticide-treated net (ITN) is one of the most frequently advised methods for preventing malaria during pregnancy. Contrary findings have been reported in various studies on ITN utilization among pregnant women in Ethiopia. Therefore, this study was aimed to estimate the pooled prevalence of ITN utilization and its associated factors among pregnant women in Ethiopia. Methods Published articles from PubMed, Google Scholar, Science Direct, AJOL and Cochrane library were systematically searched. All cross-sectional studies on ITN utilization among pregnant women were included in this meta-analysis. To estimate the pooled prevalence and odds ratio, a random-effect model was used; and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg’s and Egger’s tests were used to identify possible publication bias. Results Ten cross-sectional studies with 7,161 participants were included. The pooled prevalence of ITN utilization among all pregnant women who had access to ITN in Ethiopia was 59.42% (95% CI 51.14, 67.69). Statistically significant heterogeneity was observed (I2 = 97.7%; p < 0.0001). Higher educational status (OR = 3.47, 95% CI 2.32, 5.2), pregnant women who had antenatal care visits (OR = 2.37, 95% CI 1.97, 2.65) and having good knowledge of malaria prevention practices (OR = 10.63, 95% CI 5.31, 21.29) were associated with ITN utilization among pregnant women. Conclusion The utilization of ITNs among pregnant women was much lower than the national target. Higher education status, attending ANC and a good level of knowledge were found to be independent predictors of ITN utilization. Improving women’s understanding of ITNs will enhance their use, and the government and health sectors should encourage pregnant mothers to enroll in antenatal care.

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