The role of social marketing theory in assessing insecticide-treated net usage intentions among pregnant women in Ghana

Purpose: Despite the efforts to improve the usage of insecticide-treated nets (ITNs) among pregnant women in endemic malaria countries like Ghana, its usage still remains low. Therefore, this study aims to assess the intention to use ITNs and actual usage behaviour among pregnant women in Ghana using the integrated model of behaviour prediction (IMBP) and explore factors preventing its usage. Design/methodology/approach: A structured questionnaire was administered to 310 respondents using a convenience sampling technique, and the data were analysed using multiple regression. Exploratory data collected through an interview guide was analysed using Kvale and Brinkman’s (2015) five-step approach. Findings: The findings indicate a significantly positive association between intention to use ITN and actual usage of ITN among pregnant women in Ghana. Attitude and normative beliefs were the most significant predictors of intention to use ITNs among pregnant women. The result further shows that despite the generally positive perception of the effectiveness of the ITN in malaria prevention and positive intention to use it, its actual usage remains low because of discomfort (primarily associated with heat, irritation, heat rashes, suffocation and vomiting, size and design, reactions to ITN’s chemicals and misconceptions about ITNs causing cancer. In this study, the implications are discussed. Originality/value: This study applied the IMBP to ITNs usage intention among pregnant women in a developing market context and found the model to predict ITN usage intention effectively.