Determinants of the use of insecticide-treated nets and intermittent preventive treatment of malaria among pregnant women in Angola

Background The determinants of insecticide-treated nets (ITNs) use and uptake of three doses or more of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp 3+) among pregnant women can vary between regions and is not well studied in Angola.Methods This study analysed secondary data of a cluster-randomized controlled trial that evaluated the impact of the Maternal and Child Health Handbook (MCH-HB) on the continuum of care among pregnant women and mothers in Angola from 2019 to 2020. Those who received antenatal care (ANC) were analysed. Multivariable logistic regression analyses were performed to assess factors associated with ITN use and IPTp 3+ uptake.Results Among 8336 participants, 62.7% used ITNs and 48.7% achieved IPTp 3+. Only 31.7% achieved both. Single women were less likely to use ITNs. Women who completed secondary education, were wealthier and achieved IPTp 3+ were more likely to use ITNs. Teenagers, multiparous mothers, rural area residents and those who attended ANC later were less likely to achieve IPTp 3+. Those who completed secondary education, were wealthier, had longer travel times to health facilities and were in the MCH-HB group were more likely to achieve IPTp 3+.Conclusions The identified risk groups can be targeted for interventions to improve coverage.