Reported knowledge, attitudes and practices regarding malaria and mosquito net use among women seeking antenatal care in south-western Tanzania

To improve control measures against malaria, Tanzania has increased the distribution of free and subsidized insecticide-treated mosquito nets (ITNs) to pregnant women. However, data on ownership and use of ITNs, as well as knowledge, attitudes and practices of these women regarding malaria are scarce. The objective of this study was to describe knowledge, attitudes and practices towards malaria, frequency of bed net use and level of ownership of bed nets among women seeking antenatal care in Iringa regional hospital, southern Tanzania. This cross-sectional study involved women attending antenatal clinic at Iringa Regional Hospital in south-western Tanzania. A pre-tested structured questionnaire was applied. Among the 222 pregnant women included, 173 (78%, 95%CI, 72-84.2) owned a bed net, and 150 (68%, 95%CI, 61- 75) reported to sleep always under a bed net. The use of bed nets was mentioned by 142 (64%, 95%CI, 56.2-72). Of the 46 women who did not own a bed net, seven (15.2%) reported cost as the main obstacle for owning one. About 53% (95%CI, 44-62) preferred to use mosquito nets they bought rather than the one provided for free. Several factors such as gravidity, fearing of getting malaria, knowledge on the cause, marital status, and ways used to prevent malaria were significantly associated with mosquito net ownership (all P<0.001). Education level and gravidity were associated with the behaviour to sleep always under bed nets (P<0.002). Multigravidae (2-4 pregnancies) (OR 2.1, 95%CI 1.2-4.8) and married women (OR, 1.9, 95%CI, 1.2-5.2) were more likely to own a net, as compared to primigravidae and single women. In conclusion, ITNs ownership and use among pregnant women was good and they preferred to use the nets they bought from private sector. Thus, integrating public and private sector will improve the distribution and coverage of insecticides treated mosquito among high risk groups, such as pregnant women.