Abstract
INTRODUCTION: In spite of the increase in the number of distributed mosquito nets, and awareness campaigns on its efficacy in malaria control in sub-Saharan Africa with high burden of malaria, there is a dearth of study on the effects of malaria messages on use of mosquito nets by under-five children (U5 children). Thus, the objectives of this study were to compare the use of mosquito nets by under-five children in four West African countries; and to investigate the predictive influence of exposure to malaria messages on the use of mosquito nets U5 children. METHOD: The data was from post-2020 Malaria Indicator Surveys (MIS) on nationally representative samples of women aged 15-49 years in four West African countries of Liberia, Mali, Niger and Nigeria. Data analysis involved descriptive statistics, chi square test and multilevel logistic regression models. RESULTS: The proportion of under-five children who slept under mosquito nets ranged from 47% in Nigeria to 86% in Niger. The highest proportions of respondents from Liberia (38%) and Niger (19%) got information on malaria from health facilities while the highest proportions of 31% and 27% of respondents in Mali and Nigeria respectively got information from the mass media. The bivariate chi square test results of net use showed significant association across all the population groups in all the countries with the exception of malaria information from mass media in Liberia, Mali and Niger. In the full regression model, Liberia (OR = 1.31), Mali (OR = 9.90), and Niger (OR = 3.67), had significantly increased odds the odds of U5 children sleeping with mosquito nets while Nigeria (OR = 0.31) exhibited significantly reduced odds of U5 children sleeping with mosquito nets. Other factors which significantly influenced U5 children sleeping with mosquito nets in all the countries were malaria information from health facilities, number of U5 children in households, size of households, and regions of residence. CONCLUSION: The study among other things recommends the need for more enlightenment campaigns on the use of mosquito especially by health workers in health facilities. There is also need for region-specific interventions based on significant predictors of the use of mosquito nets in locations where respondents reported lesser proportion of U5 children who slept under mosquito nets.