Malaria remains a significant public health issue in urban settings of sub-Saharan Africa, including Ethiopia. Urban youth aged 18-25 are at high risk due to their lifestyle and geographic distribution. A mixed-methods approach was employed, combining quantitative survey data with qualitative interviews. Data were collected from a stratified random sample of 500 youths aged 18-25 in selected cities, supplemented by focus group discussions (FGDs). The analysis revealed that only 34% of surveyed youths reported using ITNs regularly, significantly lower than expected given the high malaria incidence. Despite efforts to increase ITN use through community health campaigns, there is a persistent gap in adoption rates among urban youth. Socio-economic disparities and cultural factors play a critical role. Interventions should prioritise education on the efficacy of ITNs and address socio-economic barriers such as cost and access to healthcare facilities. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.