KNOWLEDGE AND UTILIZATION OF INSECTICIDE-TREATED MOSQUITO NETS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT UGBOR PRIMARY HEALTH CENTER, BENIN CITY

TOPIC: KNOWLEDGE AND UTILIZATION OF INSECTICIDE-TREATED MOSQUITO NETS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT UGBOR PRIMARY HEALTH CENTER, BENIN CITY

TOPIC IS SUITABLE FOR:
1-Department of Nursing Science
2-Department of Public Health
3-Department of Community Health
4-Department of Environmental Health
This research material contains:
1-Chapter One to Five
2-Recent References/Citations
3-Tables/Charts/Graphs in Chapter Four
4-Accurate Data Analysis
5-Table of Contents
6-Questionnaire

ABSTRACT 
This study was carried out to examine knowledge and utilization of insecticide-treated mosquito nets among pregnant women attending antenatal clinic at Ugbor Primary Health Center, Benin City. The study was specifically carried out to assess the level of knowledge of insecticide-treated mosquito nets among pregnant women, determine the level of utilization of insecticide-treated mosquito nets among pregnant women, identify sources of information on insecticide-treated mosquito nets among pregnant women, examine factors influencing utilization of insecticide-treated mosquito nets among pregnant women and determine the relationship between knowledge and utilization of insecticide-treated mosquito nets among pregnant women. The study employed the descriptive research design. The population of the study was 250 pregnant women attending antenatal clinic at Ugbor Primary Health Center Benin City while the sample size of 154 was determined using Taro Yamane formula and a validated sample size of 139 was used. The participants were selected using multi-stage sampling technique involving stratified and convenience sampling. The questionnaire was used for data collection, while the data collected were analyzed using frequency tables, percentages, and chi-square statistical tool via SPSS. From the responses obtained and analyzed, the findings revealed that 71.4% of respondents demonstrated good knowledge of insecticide-treated mosquito nets while 28.6% showed poor knowledge. The study also showed that 58.3% of respondents utilized insecticide-treated mosquito nets while 41.7% did not utilize them. It further revealed that 67.6% obtained information from health workers and media sources while 32.4% had poor sources of information. The chi-square results showed significant relationships between knowledge and utilization (χ² = 41.86, p = 0.000), sources of information and utilization (χ² = 38.52, p = 0.000), and influencing factors and utilization (χ² = 44.18, p = 0.000). The study therefore recommends that nurses should intensify health education on ITNs, government should ensure free and continuous distribution of mosquito nets, and health institutions should strengthen antenatal counseling services to improve utilization among pregnant women.
Keywords: Insecticide-treated mosquito nets, Pregnant women, Utilization, Knowledge, Malaria prevention.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background of the Study
Malaria remains one of the most significant public health challenges globally, particularly in tropical and subtropical regions(WHO,2023). Despite being a preventable and treatable disease, it continues to pose a major threat to human health, especially among vulnerable populations such as pregnant women and children under five years of age. According to the World Health Organization (WHO), millions of people worldwide are at risk of malaria infection worldwide, with a substantial proportion residing in sub-Saharan Africa where transmission remains high due to favorable climatic and environmental conditions (World Health Organization, 2013).
Pregnancy is a period of increased susceptibility to malaria infection due to physiological and immunological changes that reduce a woman's ability to fight infections. Malaria in pregnancy is associated with severe maternal and festillbirthtal complications, including maternal anaemia, spontaneous abortion, , low birth weight, and increased maternal and neonatal mortality(WHO, 2024). In endemic regions like Nigeria, malaria contributes significantly to the maternal health burden and accounts for a considerable proportion of antenatal complications ( WHO, 2012).
In Nigeria, malaria remains a leading cause of morbidity and mortality, accounting for a large percentage of outpatient visits and hospital admissions. Studies have shown that a high proportion of pregnant women suffer from malaria during pregnancy, thereby increasing the risk of adverse pregnancy outcome (Noland et). The financial and social burden of malaria is also substantial, affecting household income, productivity, and overall quality of life.
In response to this persistent challenge, the use of insecticide - treated mosquito nets (ITNs) has been identified as one of the most effective and cost-efficient strategies for malaria prevention. ITNs work by providing a physical barrier against mosquito bites while also killing or repelling mosquitoes that come into contact with the insecticide-treated fabric. Evidence has shown that consistent use of ITNs can significantly reduce malaria transmission, morbidity, and mortality. For instance, ITNs have been reported to reduce malaria episodes by up to 50% and decrease child mortality by a significant margin in endemic regions (vincent, 2020).
Despite the proven effectiveness of ITNs, their utilization remains suboptimal in many malaria-endemic communities. Several studies have indicated that while awareness of ITNs is relatively high among pregnant women, actual usage rates are considerably lower(Solanke et al., 2023).Factors contributing to poor utilization include discomfort due to heat, perceived inconvenience, difficulty in hanging the nets, inadequate supply, and behavioral attitudes towards preventive health practices (Aina & Odoko et al., 2017). These challenges continue to undermine malaria control efforts, particularly in rural and semi-urban settings.
Research conducted in different parts of Nigeria has also revealed variations in both knowledge and utilization of ITNs among pregnant women, often influenced by educational level, socioeconomic status, and access to health education. For instance, studies have shown that although many pregnant women possess basic  of ITNs, only a fraction consistently use them, despite receiving them either free of charge or through health facility distribution programs (Vincent, 2020).
Similarly, findings from antenatal clinic-based studies have highlighted that knowledge alone does not always translate into practice. Even when ITNs are available, utilization is often hindered by misconceptions, lack of perceived risk, and environmental discomfort. This gap between knowledge and practice poses a significant challenge to malaria prevention efforts among pregnant women.
In Ugbor Primary Health Centre in Benin City, malaria remains a common health challenge among pregnant women attending antenatal clinics. Despite ongoing efforts such as health education and the distribution of insecticide treated mosquito nets, consistent utilization may still be inadequate. This suggests the possibility of gaps between knowledge and actual use of insecticide treated mosquito nets (ITNs) among pregnant women. Therefore, there is a need to assess the level of knowledge and utilization of the insecticide treated mosquito nets among pregnant women attending antenatal clinic at Ugbor Primary Health Centre, Benin City. The  finding are expected to provide useful information for healthcare providers, policymakers, and public health practitioners in designing more effective interventions aimed at improving ITN utilization and reducing the burden of malaria in pregnancy.

1.2 Statement of the Problem 
Malaria has been one of the major infectious diseases that occur among individuals in African countries, and Nigeria is not exempted but is also greatly affected. Most cases of hospital visits or admissions are caused by malaria, and pregnant women are not exempted. Infact they are at higher risk or more vulnerable due to reduced immunity during pregnancy. And malaria during pregnancy will result in complications like anemia, miscarriage, low birth weight and maternal mortality (World Health Organization [WHO], 2023).
Several studies has been done on how to prevent malaria especially for pregnant women and the use of insecticide-treated mosquito nets has been recommended as an effective method of malaria prevention among pregnant women but many of them do not use them regularly or consistently in Nigeria despite government and non - government organizations effort in distribution of insecticide treated mosquito nets (ITNs) , so  there is reoccurrence of malaria (Auta, Demographic and Health Surveys). Studies have also shown that factors such as poor knowledge of the availability and use of Insecticide treated mosquito nets, discomfort such as heat, and misconceptions and cultural beliefs regarding the effectiveness and safety of ITNs contribute to low utilization of insecticide-treated nets among pregnant women attending antenatal clinic in South-South Nigeria (Runsewe-Abiodun). Therefore, there is a need to assess the knowledge and utilization of insecticide-treated mosquito nets among pregnant women attending antenatal clinic at Ugbor Primary Health Center, Benin City.
1.3 Objective of the Study
To assess the knowledge and utilization of insecticide treated mosquito nets (ITNs) among pregnant women attending antenatal clinic at ugbor primary health center Benin City. 
Specific objectives of the study 
1.To assess the level of knowledge of Insecticide treated mosquito nets (ITNs) among pregnant women attending antenatal clinic at Ugbor Primary Health Center Benin City.
2.To assess and determine the level of utilization of insecticide treated mosquito nets (ITNs) among pregnant women attending antenatal clinic at Ugbor Primary Health Center Benin City.
3.To identify the sources of information on Insecticide treated mosquito nets among pregnant women attending antenatal clinic at Ugbor Primary Health Center Benin City.
4.To examine the factors influencing the utilization of insecticide-treated mosquito nets among pregnant women attending antenatal clinic at Ugbor Primary Health Center Benin City.
5.Determine the relationship between knowledge and utilization of insecticide-treated mosquito nets among pregnant women attending antenatal clinic at Ugbo Primary Health Center Benin City.
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Questions 
1.5 Research Hypothesis 
1.6 Significance of the Study 
1.7 Scope of the Study 
1.8 Definition of Terms:

CHAPTER TWO
LITERATURE REVIEW (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of insecticide-treated mosquito nets, knowledge of insecticide-treated mosquito nets, utilization of insecticide-treated mosquito nets, benefits of insecticide-treated mosquito nets, and factors influencing the utilization of insecticide-treated mosquito nets among pregnant women etc. The chapter is sub-grouped into the following major headings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
RESEARCH METHODOLOGY  (Preview)
Presented below is a snapshot of key areas of the study methodology, the full and detail chapter three methodology is contained in the instant download document.

Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprised pregnant women attending antenatal clinic at Ugbor Primary Health Center, Benin City.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 154 participants.
Sampling Technique: The study employed a multi-stage sampling technique involving stratified, proportionate allocation, and convenience sampling methods to select the respondents.
Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses. Inferential statistics, such as cross-sectional Chi-square, were used to test the hypotheses.
Full outline for chapter three:
3.1 Research Design
3.2 Study Setting
3.3 Population of the Study 
3.4 Sample and Sampling Techniques 
3.5 Instrument for Data Collection 
3.6 Validity of the Instrument 
3.7 Reliability of the Instrument 
3.8 Procedure for Data Collection 
3.9 Method of Data Analysis
3.10 Ethical Consideration

CHAPTER FOUR; PRESENTATION OF RESULTS 
MAJOR FINDINGS (Preview)
The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made: 

i. The study found that pregnant women attending antenatal clinic at Ugbor Primary Health Center, Benin City, demonstrated a good level of knowledge of insecticide-treated mosquito nets, as evidenced by the majority of respondents agreeing that ITNs prevent malaria and reduce mosquito bites. The corresponding hypothesis test showed a Chi-square value of 41.86 and a p-value of 0.000 (p < 0.05), leading to the rejection of the null hypothesis and indicating a significant relationship between knowledge and utilization of ITNs.

ii. The study found that pregnant women attending antenatal clinic at Ugbor Primary Health Center, Benin City, demonstrated a considerable level of utilization of insecticide-treated mosquito nets, as evidenced by the majority of respondents agreeing that they sleep under ITNs regularly and ensure proper installation before use.

iii. The study found that health workers, radio, television, social media, community health campaigns, family, and friends were important sources of information on insecticide-treated mosquito nets among pregnant women. The corresponding hypothesis test showed a Chi-square value of 38.52 and a p-value of 0.000 (p < 0.05), leading to the rejection of the null hypothesis and indicating a significant relationship between sources of information and utilization of ITNs.

iv. The study found that availability of ITNs, adequate awareness, and support from health workers encouraged utilization, while high temperatures and discomfort could discourage regular use. The corresponding hypothesis test showed a Chi-square value of 44.18 and a p-value of 0.000 (p < 0.05), leading to the rejection of the null hypothesis and indicating a significant relationship between factors influencing utilization and the use of ITNs.

v. The study found that adequate knowledge of insecticide-treated mosquito nets was associated with more consistent utilization among pregnant women, as evidenced by respondents with good knowledge being more likely to use ITNs than those with poor knowledge. The corresponding hypothesis test showed a Chi-square value of 41.86 and a p-value of 0.000 (p < 0.05), confirming a statistically significant relationship between knowledge and utilization of ITNs.

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATIONS
This chapter covers the following outline:
5.1 Discussion of the Findings
5.2 Implication of the Study to Nursing
5.3 Conclusion
5.4 Recommendations
5.5 Limitations of the study
5.6 Suggestions for Further Studies

Reference

Appendix

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