Malaria remains a significant public health challenge in Nigeria, affecting millions of lives annually.
To address this issue comprehensively, a strategic initiative has to be applied to remove obstacles hindering malaria eradication by focusing on robust environmental management.
Malaria is a mosquito-borne infectious disease transmitted by the bites of female Anopheles Mosquitoes, which thrive in temperate and tropical climates.
Mosquito bites to humans transmit a parasite known as Plasmodium Falciparum, and climatic conditions in Nigeria make malaria bites and transmission of the parasite common and pose a health burden to the people.
Hyperendemicity refers to the persistently high levels of malaria sicknesses in the Nigerian environment.
Regular occurrences of malaria cases, deaths, and disabilities are abnormally high and impact the majority of the Nigerian population negatively
Among the major reasons for the increase in malaria disease is the presence of drug-resistant species of the vector mosquito, the preponderance of enabling environments such as poor living conditions, and the inadequacy of primary health infrastructure to treat the disease.
Malaria eradication program in Nigeria is faced with several constraints such as poor living environmental conditions, the lack of basic sustainable infrastructures, underfunding of the health structure, limited access to healthcare, program inconsistency, and lack of oversight.
Other constraints are posed by political, social and economic structures of Nigeria and the inadequate efforts to educate the public.
The obstacles inhibiting Malaria elimination in Nigeria include political, social, and economic situations.
The society, political economy, history, culture and the social environment, all have impacts on the nature of disease, population affected and their access to healthcare.
Also, limited and dysfunctional health facilities in the places where the vulnerable population live pose a problem to seeking care in a timely manner and receiving preventive education.
Nigeria’s climatic condition of high temperatures and heavy rainfalls encourage mosquito breeding and malaria, as well as increase mosquito population and transmission dynamics.
These conditions promote mosquito bites and malaria transmission year-round especially to people living in swampy and unhygienic environments.
To combat the increasing incidence of malaria, urgent actions and collective effort from the public are necessary. The use of Insecticide-Treated Nets (ITNs) is crucial as they serve as physical barriers against mosquitoes, reducing the risk of infection, particularly for vulnerable groups like pregnant women and children under 5. Another effective measure is eliminating potential breeding sites by emptying, covering, or treating containers that hold water, such as buckets, flowerpots, and discarded car tyres.
Proper maintenance of drainage systems is also vital to prevent stagnant water accumulation.
As part of the national effort to address the challenges of Malaria in Nigeria, ACOMIN was engaged by Catholic Relief Services (CRS) under the ongoing Global Fund (GF) Malaria Grant to continue implementing the civil society component, building on the successes of the previous phase of the grant.
The grant is currently being implemented in 13 GF-supported states, namely Kaduna, Kano, Katsina, Jigawa, Kwara, Niger, Taraba, Gombe, Yobe, Adamawa, Ogun, Osun and Delta, covering eight LGAs in each state.
In Adamawa state, the selected LGAs are Ganye, Girei, Maiha,Mayo-Belwa, Mubi South, Numan, Song and Yola South.
Approaching the fight against malaria through community-centred initiatives – such as the Community-Led Monitoring project being implemented by ACOMIN – brings many advantages.
These include increased ingenuity, flexibility in tackling challenges by identifying and addressing the root cause of failed interventions; and enhanced accountability among others
In Adamawa state, the community-centred initiative being implemented by ACOMIN has yielded the following successes this year:
Increased community commitment in health and other community developmental affairs; increased infrastructural development in ACOMIN implementing Primary Health facilities across the state; integration of reliable community stakeholders like District Heads, religious leaders, traditional title holders, community youths and other community stakeholders into project ownership.
CALL TO ACTION: Addressing the Barriers to Malaria Elimination
For Nigeria to progress in the control and elimination of malaria, it should implement a combination of measures that include mosquito avoidance, improved access to diagnostics and treatment, health education and promotion and community partnership.
WE therefore call on governments, private sector and other stakeholders in malaria to commit to the following:
The National Health Insurance program enjoyed by the formal sector should be extended to other citizens of Nigeria, particularly the poor and most vulnerable.
The poor often are less educated and unemployed and consequently lack the ability to pay out-of-pocket for high costs associated with frequent illnesses.
Funding and finances for primary health delivery should be carefully mapped out and sanctioned against any misappropriation or mismanagement; to enable a robust public health program at all ward levels in the local government.
Communication and education programs can raise knowledge and awareness and, in turn, improve testing and care-seeking.
There is a great need to educate, engage, and empower the communities to embrace any behavior change relevant to achieving success in malaria, HIV, and TB control in Nigeria.
Every ward should commit to health promotion and education programs to increase awareness of prevention measures; and promote community participation and adherence to evidence-based strategies.
Commit adequate resources through advocacy and partnerships, for the full and effective implementation of all planned interventions, including through involvement of the private sector, and community participatory approaches.
Community members should actively support and advocate for their local Primary Healthcare Centers (PHCs).
Community involvement is crucial in ensuring the sustainability and effectiveness of these centres. Additionally, community support can manifest through volunteering, donating resources, or participating in advocacy efforts to secure increased funding and resources for PHCs.
Malaria elimination should be seen as a project that demands immediate attention.
This means that the government should provide adequate financial and human resources to supplement international support for elimination program. Therefore, a separate funding allocation and management for the health sector will help promote continuity, accountability, improve grassroots outreach, intervention and engagement. Nigeria should set up and implement a functional malaria surveillance system to collect data on malaria cases and monitor eradication progress.
Malaria can only be eradicated in Nigeria when the government feels committed to it as a national responsibility. Malaria hyper-endemicity is a major public health crisis that requires government’s deliberate and consistent efforts to follow recommended strategies to eliminate and eradicate malaria in Nigeria and save the people from deaths and malaria associated health consequences.