Determinants of Long-Lasting Insecticide-Treated Bed Net Utilization Among Pregnant Women in Gechi District, Buno Bedele Zone South West Ethiopia: A Community-Based Cross-Sectional Study.

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Long-lasting insecticide-treated bed nets (LLITNs) are a key malaria prevention method, but their consistent use in Ethiopia, particularly among rural mothers, remains challenging. Information on LLITN usage among pregnant women in resource-limited settings is especially scarce. This study investigated LLITN utilization and the factors influencing its use among pregnant women in the Gechi district, Southwest Ethiopia, in 2024. A community-based cross-sectional study was conducted from June to July 2024, including 422 randomly selected pregnant women. Data collection employed a pretested questionnaire, and logistic regression analysis was utilized to identify factors influencing LLITN usage. Variables with a P-value < .25 in univariable analysis were incorporated into the multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed, and statistical significance was set at P ⩽ .05. The model's performance was assessed using the Hosmer-Lemeshow goodness-of-fit test. The finding of this study revealed that 93.9% of the respondents had LLITN, and the current utilization status of pregnant women was 46.5% [41.7%-51.3%]. The low level of utilization was significantly associated with women' education, parity, antenatal care (ANC) attendance, and family size. Accordingly, women without formal education were 52% less likely [AOR: 0.48, 95% CI: 0.28-0.81]; those with primipara were 1.98 times more likely [AOR: 1.98, 95% CI: 1.30-3.03]; a family size of less than 5 was 2.53 times [AOR: 2.53, 95% CI: 1.61-3.87] more likely, and women who attended at least 1 ANC visit were 2.08 times more likely [AOR: 2.08, 95% CI: 1.21-2.58] to use LLITN. The pregnant women's LITN utilization in settings was low, associated with women's education, parity, antenatal care attendance, and family size. Key players should focus on awareness creation and ANC follow-up to reduce illness during pregnancy, particularly in rural, hard-to-reach settings.