A long walk towards a malaria-free Nigeria for children?

Malaria, as many already know, is a disease caused by bites of an infected female anopheles mosquito. Nigeria sadly is the largest malaria epidemic country in Africa. In 2020, the country accounted for 27% of the global malaria cases (65million cases) and 32% of the global malaria death (200,640 deaths) [1].

Malaria in children otherwise known as Pediatric Malaria is one of the leading causes of child mortality in Nigeria. Children within the country are one of the most vulnerable groups; with about 300,000 children reported to die annually from the disease in the country [2].

This could be attributed to the growing immune system of this population subgroup (especially those under the age of five), which provides little or no resistance to malaria parasites. Symptoms of pediatric malaria include vomiting, fever, and in severe cases anaemia or death. Pediatric malaria can also be diagnosed via rapid diagnostic tests and microscopy.

Within the country, numerous programs and policies have been set up to eliminate pediatric malaria. However, the disease remains a major public health concern. Hence, there was the need to understand the geographic pattern of pediatric malaria transmission in Africa’s most affected country as well as identify the factors responsible for the observed occurrence and what could be done to reduce morbidity and mortality among children.

In the light of the above, I examined the spatio-temporal pattern of pediatric malaria from 2008-2018 from the Nigeria Demographic Health Survey. The following findings were made.

Having examined the spatial pattern, there was the need to also determine if there were spatial clusters in the country. Are there clusters of regions with high values (hotspot regions) or regions with low values (coldspot regions)? Identification of spatial clusters would help to determine unifying factors for cold/hotspot regions as the case may be. This would go a long way in influencing programmes/policies to be directed towards the alleviation of pediatric malaria in the country.

Following quantitative analysis, poverty among several possible risk factors in the country was identified as the only significant factor responsible for the persistence of pediatric malaria.

Children affected by poverty are deprived of access to good nutrition required for the development of a strong immune system to fight against any disease including malaria, quality health care services that include prompt diagnosis and treatment of malaria, a clean environment that discourages the breeding of mosquitoes that spread malaria and quality housing that reduces exposure to mosquito bites.

In the country, 25% of children live below the international poverty line of less than $1.9 a day [3]. This could be further interpreted as 1 out of 4 children live in poverty in the country.

According to [3] “A Nigerian child is considered as multi dimensionally poor if the child is deprived in at least 3 dimension at the same time”.

To the credit of the Nigerian government, numerous policies and programmes have been put in place to alleviating child poverty directly or indirectly in the country. Some of these programmes include Operation Feed the Nation (OFN), National Poverty Eradication Programme (NAPEP), Social Welfare Services Schemes (SOWESS), National Economic Empowerment and Development Scheme (NEEDS), State Economic Empowerment and Development Scheme (SEEDS), Local Economic Empowerment and Development Scheme (LEEDS) and School Feeding Programmes to mention a few. However, child poverty in the country remains a lingering economic and societal headache in the country. What then could be the missing link?

First, there is the need to determine the root cause of child poverty particularly in states with high poverty levels in the country. Policies, programmes and resources can then be channeled accordingly to eliminating the identified cause in these states. Local and state governments should also be made actively involved in the coordination of poverty allevation programmes and the implementation of policies.

Second, the government at all levels should work hand in hand to ensure that primary health centers across the country are properly financed, fully operational and easily accessible. These centers could be used to provide free malaria services to children under the age of five, freely distribute mosquito nets and nutrition supplement to households with children.

Third, there is a need for the government to improve the infrastructural provision across the country particularly in the rural areas where child poverty is more widespread. This would foster economic growth and development in such areas, opening more opportunities of income generation for households.

Lastly, literacy and skill acquisition programmes should be directed to households with low levels of education. These schemes could be reinvented and mainstreamed into national poverty alleviation strategies. These creates more avenues for income generation and improvement in the standard of living of children in the affected households.

All these with the great hope that someday Nigeria will be malaria free for our children!