We conducted cross-sectional study with multi-stage sampling in Matayos Sub-County, Busia County. Data were collected using questionnaire from June-July 2022. Data was analyzed by Stata version 16.  Universal coverage was defined as ownership of one PBO net for two household members. Proper utilization was defined as sleeping under a mosquito net the previous night, net usage on all days of the week, hanging the net adequately. Data was collected on net ownership, access, utilization. Proper utilization of nets was the dependent variable. We calculated measures of central tendency and dispersion for continuous variables and proportions for categorical variables. Chi-square was used to test for association between dependent and independent variables. Variables with a p-value&amp;lt; 0.05 were considered statistically significant. 