Malaria remains one of the leading causes of morbidity and mortality in sub-Saharan Africa, with children under five years being the most vulnerable group. Insecticide-treated nets (ITNs) are among the most effective preventive strategies, yet their acceptance and utilization often fall below expected levels despite widespread distribution. This study assessed the acceptance and utilization of ITNs in malaria prevention among parents of under-five children in Ozuoba, Rivers State. The study aimed to determine the knowledge of malaria transmission and prevention, assess the acceptance of ITNs, and evaluate their utilization among parents of under-five children in the study area. A descriptive survey design was adopted, with a sample size of 153 parents selected through multistage sampling. Data were collected using a structured questionnaire and analyzed using descriptive statistics such as frequencies and percentages, presented in tables and charts. Findings revealed that parents demonstrated a high level of knowledge of malaria transmission and prevention, with over 80% recognizing mosquito bites as the main cause of malaria and acknowledging the protective role of ITNs. Acceptance of ITNs was also high, particularly when provided free of charge; however, willingness to purchase ITNs independently was lower, highlighting affordability as a barrier. Utilization was moderate, with 62.1% reporting ownership of ITNs, but only 52.3% consistently ensuring their under-five children slept under them. Heat discomfort and difficulty with installation were cited as key challenges. The study concluded that while ITN knowledge and acceptance were satisfactory, utilization remained suboptimal due to socioeconomic and practical barriers. It recommended sustained free or subsidized ITN distribution, intensified health education by nurses and health workers, improved community engagement, and design modifications for greater comfort. Future studies should explore cultural influences and seasonal variations in ITN use.

Keywords: Malaria prevention, Insecticide-treated nets, Acceptance, Utilization, Under-five children.