advancing malaria chemoprevention equity in sub-saharan africa: integrating seasonal malaria chemoprevention (smc) into universal health coverage frameworks
1
Independent Researcher, Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A1634
ABSTRACT
BACKGROUND:
in nigeria, malaria disproportionately affects northern states like kebbi, sokoto, and zamfara (prevalence 49%, 37%, and high incidence per dhis2 2023-2025, contrasting with year-round lower burdens in southern states such as anambra, abia, and akwa ibom (5-30% access to prevention). seasonal malaria chemoprevention (smc) has reduced incidence by 50% in implementing areas (e.gnorthern nigeria studies), but integration into universal health coverage (uhc) is needed for equity and sustainability. this aligns with the congress theme of “health without borders: equity, inclusion, and sustainability,” particularly the equity in public health, maternal-child health, and health systems strengthening tracks, by targeting vulnerable populations for health without borders.
METHODS:
we analyzed public dhis2 data (2020-2025) for smc coverage and malaria metrics in smc-eligible northern states versus non-smc southern states nmis 2021 and mics 2021 provided baseline prevalence and barriers (e.g., stockouts, access)we evaluated smc integration via uhc frameworks, using malaria consortium reports (2024 coverage: 88-97% per cycle in northern states)
RESULTS:
dhis2 shows northern high burden (e.g sokoto: 114,831 cases sep 2023; kebbi: 53,277 oct 2022), with smc reaching 11.5 million children in nigeria (2024), including these states, yielding 74.5-87.1% full-cycle coverage and a documented 50% incidence reduction in pilots (malaria consortium 2025 plausibility study). southern states report gaps in iptp (e.g anambra: 23% equity in access). integration reduced barriers, but stockouts persist (25% in zamfara). uhc alignment enhanced inclusion of vulnerable children (3-59 months), addressing 97% population at risk.
CONCLUSIONS:
integrating smc into uhc frameworks advances chemoprevention equity by targeting high-burden northern regions while adapting to southern needs (e.g., iptp focus), promoting inclusive, sustainable systems. key lessons include community-based delivery for better coverage recommendations for national scale-up could reduce malaria mortality (30.9% global share in nigeria, 2023 world malaria Report and support nigeria’s national malaria strategic plan goals, fostering health inclusion without borders
in nigeria, malaria disproportionately affects northern states like kebbi, sokoto, and zamfara (prevalence 49%, 37%, and high incidence per dhis2 2023-2025, contrasting with year-round lower burdens in southern states such as anambra, abia, and akwa ibom (5-30% access to prevention). seasonal malaria chemoprevention (smc) has reduced incidence by 50% in implementing areas (e.gnorthern nigeria studies), but integration into universal health coverage (uhc) is needed for equity and sustainability. this aligns with the congress theme of “health without borders: equity, inclusion, and sustainability,” particularly the equity in public health, maternal-child health, and health systems strengthening tracks, by targeting vulnerable populations for health without borders.
METHODS:
we analyzed public dhis2 data (2020-2025) for smc coverage and malaria metrics in smc-eligible northern states versus non-smc southern states nmis 2021 and mics 2021 provided baseline prevalence and barriers (e.g., stockouts, access)we evaluated smc integration via uhc frameworks, using malaria consortium reports (2024 coverage: 88-97% per cycle in northern states)
RESULTS:
dhis2 shows northern high burden (e.g sokoto: 114,831 cases sep 2023; kebbi: 53,277 oct 2022), with smc reaching 11.5 million children in nigeria (2024), including these states, yielding 74.5-87.1% full-cycle coverage and a documented 50% incidence reduction in pilots (malaria consortium 2025 plausibility study). southern states report gaps in iptp (e.g anambra: 23% equity in access). integration reduced barriers, but stockouts persist (25% in zamfara). uhc alignment enhanced inclusion of vulnerable children (3-59 months), addressing 97% population at risk.
CONCLUSIONS:
integrating smc into uhc frameworks advances chemoprevention equity by targeting high-burden northern regions while adapting to southern needs (e.g., iptp focus), promoting inclusive, sustainable systems. key lessons include community-based delivery for better coverage recommendations for national scale-up could reduce malaria mortality (30.9% global share in nigeria, 2023 world malaria Report and support nigeria’s national malaria strategic plan goals, fostering health inclusion without borders
| eISSN: | 2654-1459 |
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