Background Malaria is among the leading causes of morbidity and mortality particularly among women and children in sub-Saharan Africa and remains a public health challenge. Over the years, provision of insecticide mosquito nets (ITNs) for individuals and households have been on the forefront of various organizations. Focus has been on proportion of population with access to ITNs at the expense of usage proportion. This study examined the factors associated with the use of ITNs among women in Ghana. Methods This study used a cross-sectional data obtained from the 2016 Ghana Malaria Indicator Survey (GMIS). A sample of 4,267 women aged 15–49 who possessed at least one mosquito net was included in this study. Use of ITNs was the outcome variable. Descriptive statistics and multilevel binary logistic regression were employed. Results were provided in tables with a significance level set at P < 0.05. Results Out of the 4,267 total sample, more than half (55.9%) were users of ITNs. Women aged 15–24 were less likely (aOR = 0.680 Crl:0.576–0.803) to use ITNs compared to women aged 35 years and above. Women with no education were more likely (aOR = 1.282 Crl:1.047–1.570) to use ITNs compared to women with secondary or higher educational level. Poor women also had significantly higher odds (aOR = 2.005 Crl:1.612–2.495) of using ITNs than similar women who were rich. Women who lived in least disadvantaged communities had higher odds (aOR = 1.358 CrI:1.055–1.748) of using ITNs compared to women in most disadvantaged communities. Conclusions Low socio-economic status was a key predictor of ITN usage in Ghana. Having no education, being poor, living in rural areas, chances of getting malaria, coverage of malaria under NHIS and being least socio-economically disadvantaged increased the likelihood of using ITNs. Interventions aimed at improving socio-economic statuses are needed to increase ITN usage in Ghana.

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