Ethiop. j. public health nutr. Insecticide treated net utilization and associated factors among households having under-five children and pregnant women in Fogera District, Northwest Ethiopia Tirunesh Mulugeta 1 , Baye Ashenefe 1 , Alemayehu Shimeka 2 and Sintayehu Abate 1 Amhara Regional Health Bureau, Bahir Dar, Ethiopia, Ethiopian public health institute, Addis Abeba, Ethiopia 2 Ethiopian public health institute, Addis Ababa, Ethiopia 3 Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia *Corresponding author: bayeh2008@gmail.com Abstract Background: Malaria is life threatening disease particularly for under-five children and pregnant women unless there is no proper use of bed nets. Evidences are limited on the use of insecticide treated net among under-five children and pregnant women. Objective: The aim of this study was to assess insecticide treated net utilization and associated factors among households having under-five children and pregnant women in Fogera district , Northwest Ethiopia. Method: Community based cross-sectional survey was conducted from October 01 to November 30, 2016. A total of 712 households were selected using two-stage random sampling technique. Data were entered using Epi Info version 7 and exported to SPSS version 20 for further analysis. Both descriptive and analytic statistics were computed. Variables having association with the outcome variable was reported using odds ratio with 95% CI. Model fitness was checked by Hosmer and Lemeshew test. Result: Insecticide treated bed net utilization among under-five children and pregnant women was 63.3%. Households having <3 sleeping spaces (AOR = 7.45; 95% CI; 3.97-14.1), nets available per house hold (≥2 nets) (AOR = 5.2; 95% CI 2.4-11.2), family size of <5 (AOR = 6; 95%CI; 2.8-12.8), being urban resident (AOR = 17.4; 95% CI; 6.3-48.1), having poor knowledge of malaria and bed net use (AOR = 0.09; ( 95% CI; 0.04,0.2) and having good perception of net use (AOR=4.2; ( 95% CI; 1.8, 10.3) were found to be significant predictors of bed net utilization. Conclusions and recommendations: In this study, insecticide treated net utilization was slightly lower than the standards set by federal ministry of health and world health organization recommendation. Bed net utilization among pregnant women and under-five children was significantly associated with number of sleeping spaces per households, number of nets available, family size, residence and perception on net use. Utilization of bet net has to be strengthened with special emphasis on households having large family size, more sleeping spaces, rural residence, poor knowledge on malaria and net use, inadequate perception about net use. Key words: Malaria, insecticide treated net, utilization Introduction Malaria is a life-threatening disease caused by plasmodium parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. Plasmodium falciparum is the most deadly malaria parasite and the most prevalent in Africa, where malaria cases and deaths are heavily concentrated. It is major health problems in the world. About 3.2 billion people – almost half of the world’s population are at risk of malaria. The African region accounted for 88% of global burden and 90% deaths of malaria In areas with high transmission of malaria, children under-five are particularly susceptible to malaria infection, illness and death and more than two thirds (70%) of all malaria deaths occur in this age group (Laurence 2016; Gobena 2012). In sub-Saharan Africa, the area most burdened by malaria; the disease is thought to cause as many as 10,000 cases of malaria-related deaths during pregnancy and causes severe complication in children and pregnant women (WHO 2015). In Ethiopia, malaria is a major public health problem where about 75% of its total area is malarious and nearly 68% (52 million) of the total population lives in areas at significant risk of malaria. As evidenced from 2010/2011 report of the Ethiopian ministry of health, malaria was the leading cause of outpatient visits, accounting for 15% of all visits and health admissions. It is one of the top ten causes of in-patient deaths among children less than five years of age and adults (Presidential malaria intuitive 2013). In April 1998, the WHO African regional organization undertook the initiative to bring malaria under control, as the continent bears 80 to 90 percent of the global malaria disease burden. World Health Organization launched a global initiative called “Roll Back Malaria” by setting goals considering the four strategic tools for prevention and Volume 2 Issue 2 ISSN 2709-1341 125 https://ejphn.ephi.gov.et