In spite of huge global investments in the production and distribution
of mosquito nets to protect people from malaria; it has continued to militate
against the reduction of mortality in Nigeria. The study, therefore, examined
the nexus between utilization of mosquito nets and malaria related under-five
health outcome. Two local government areas were randomly selected from
each of the three senatorial districts, and stratified along urban and rural
communities. Purposive sampling technique was used to select 609 mothers
within childbearing age and who had under-five children across the
communities. Descriptive statistics, Chi-square tests and logistic regression
at p<0.05, and thematic content analysis were used for data analyses. The
respondents’ age was 32.6±5.8 years, 84.6% were married/living together,
55.0% had secondary education, while 42.7% were in paid/civil service jobs.
Under-five mortality was 19.3% higher amongst rural than urban dwellers.
Ownership of mosquito nets (treated or untreated) varied by place of
residence with 60.1% and 39.9% for urban and rural areas respectively.
About 62% of the dead under-five children never slept under mosquito nets.
The likelihood of under-five mortality significantly increased by nonownership
of mosquito nets (Odds-Ratio (OR): 2.476) and reduced by
number of mosquito nets (OR: 0.278). Wrong methods adopted by mothers
in using mosquito nets, was deduced as a contributory factor causing underfive
mortality for home with fewer nets. Information on the proper use of
the mosquito nets would help achieve the goal of universal access for the atrisk
populations of children under age five and pregnant women.