By Isibhakhomen Yetunde Ikhimiukor and Seember Ishuh 

Malaria is a life-threatening disease which has led to many deaths in Nigeria and globally. Through a bite from an infected Anopheles mosquito carrying the plasmodium parasite, the disease is passed from one person to another. According to WHO’s latest World malaria report 2022, there were an estimated 241 million malaria cases and 627,000 malaria deaths worldwide in 2020. This represents about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Africa accounts for over half of Malaria deaths worldwide with Nigeria leading by 31%. Malaria is completely preventable, treatable, curable and can be eradicated, this necessitates urgent attention in its treatment and prevention especially in Nigeria. 

Malaria prevalence in Kano State 

According to Nigeria Malaria Indicator Survey (NMIS) 2021, Kano State experienced a decline in Malaria parasite prevalence from the 32% recorded in 2018 to 26% in 2021. Net use by children less than 5 years declined from 62% in 2015 to 55% in 2021. Net use by pregnant women increased from 55% in 2015 to 79% in 2018 but reduced slightly to 77% in 2021. 

Kano State with 26% has the third lowest parasite prevalence in the Northwest zone among children aged 6-59 months who have tested positive. Insecticide Treated Nets (ITN) ownership has been consistently over 80% for Kano state with a 0.1% increase between 2018 to 2021. Children under the age of 5 years and pregnant women are considered most vulnerable to the disease. 

SFH Intervention through the Zero Malaria starts with me Campaign 

The Zero Malaria Starts with me Campaign is a Pan African campaign that mobilises and empowers communities to take ownership over the fight to end malaria and keep Malaria as a top political priority. Nigeria launched the “Zero Malaria Starts with Me” initiative during the 2022 World Malaria Day event, joining about 23 other nations in the campaign. The campaign is a movement to help each country build a winning coalition for defeating malaria. 

“I have started including the need for using the nets in my Friday Sermon. I told my people during today’s sermon the importance of sleeping inside the nets together with their family” said Chief Imam Hadi Ibrahim, during one of the sessions of the Zero Malaria Starts with Me Campaign Stakeholders Meeting. 

The Zero Malaria Starts with me Campaign Stakeholders meeting organised by Society for Family Health (SFH) in partnership with National Malaria Elimination Program (NMEP) brought together over 40 stakeholders which included Traditional/community leaders, religious leaders, Ward Development Committees (WDC), the State team, and the media. The two-day stakeholders meeting was aimed at discussing achievements, challenges and recommendations in relation to the Global Fund Malaria grant implementation, increase stakeholder participation in the grant implementation, engage stakeholders in the Campaign and set-up a Zero Malaria Starts with Me campaign task team.  Dr Adebayo Ekosanmi (NMEP) led a presentation on the Global Fund Malaria (GFM) grant where he discussed the GF’s continuous efforts to end malaria. Mr. Victor O. Ameh (NMEP) spoke on malaria prevalence and the use of insecticide-treated nets in Nigeria, providing statistics for an eight-year period from 2013 to 2021 with a focus on pregnant women and young children. 

Mr Daniel Gbue (SFH) facilitated an interactive session with the participants to translate the “Zero Malaria Starts with Me” to Hausa language. The participants actively engaged in this session and unanimously agreed on the translation as “Kawar Da Zazzabin Cizon Sauro Ya Fara Daga Kaina’’. He continued by outlining the objectives, strategies, actors and implementation process of the Zero Malaria Start With Me campaign. 

The participants were further enlightened on prevention, diagnosis, and treatment of malaria led by Mrs Owoya Samuel (NMEP). During this session, she discussed the different means of preventing malaria, such as environmental protection through maintaining a clean environment, the use of Intermittent Preventive Treatment in pregnancy (IPTp) using Sulfadoxine-Pyrimethamine (SP), the use of Seasonal Malaria Chemoprevention (SMC) in children under 5 years and the use of ITNs. She also mentioned the use of the Rapid Diagnostic Test for malaria testing before treatment and the use of artemisinin-based combination therapy (ACT) for the treatment of malaria. She presented some data on the use of ITNs and the knowledge of malaria prevention among residents in Kano state. She mentioned that 85% of households in Kano own at least one ITN and 65% slept inside the net every night, 64% of children under 5 years and 76% of pregnant women slept under the net. Further discussed during the session were the challenges associated with the prevention of Malaria: 

• Poor access to SP by pregnant women due to stock out. 
• Some myths and misconceptions associated with the use of ITN such as the white nets are used to wrap dead bodies and it continuously itches the skin. 
• Failure of individuals to complete the dose of ACT. 

The session on Interpersonal Communication (IPC) strategy by Mrs Deborah Sesugh Oryiman (SFH) explained the importance of the IPC strategy to awareness creation, proper information sharing and how IPC is used to get feedback and to address misconceptions and myths about malaria. 

 

 

 

 

 

 

 

 

 

During the breakout session, participants were able to develop engagement activities for each of the stakeholders. These interventions were presented by a representative of each of the stakeholders group. A task team was set-up with the responsibility of engaging political leaders and influential members of society as well as increasing awareness and taking ownership of malaria prevention, testing, and care among communities. To that effect, a communique was adopted which highlighted key discussions and considerations as follows: 

• Stakeholders unanimously agreed on the ZeroMalariaStartsWithMe campaign, and it has been translated into Hausa Language as ‘Kawar Da Zazzabin Cizon Sauro Ya Fara Daga Kaina’. 
• Stakeholders agreed for rigorous sensitization campaign for pregnant women and children under five to be sleeping inside ITNs every night. 
• Stakeholders agreed to work hard to drive the movement for a successful ZeroMalariaStartsWithMe campaign in Kano State. 
• Stakeholders agreed on the fact that there should be robust awareness on the need for malaria test before treatment in the health facilities. 
• The stakeholders commended Kano State government for agreeing to provide all the necessary supports to Zero Malaria Task Team and also urged for more support to sustain the movement.  
• The ZeroMalariaStartswithMe Task Team would be inaugurated by the Kano State Commissioner of Health before official commencement of activities. 
• The ZeroMalariaStartsWithMe Task Team agreed to meet periodically to evaluate progress towards the achievements of its goal. 

Outcome from the Stakeholders meeting 

Participants shared their thoughts on the outcomes of the meeting and how they plan to implement the knowledge gained in their various advocacies.  

Murtala Sani, a Chief Imam from Ungogo LGA said “The Zero Malaria Start with Me Campaign is important to all Nigerian and especially in Kano State that has a number of people and is crowded. I should start with myself first by sleeping in the net with all my family as I have done so for over two years. Secondly, I have to clean my environment as it is very important. Then, I will speak with my neigbours and include the message in my sermons in the Friday mosques telling people to sleep in the nets. I would also engage with other Imams to ensure that they pass the message of sleeping inside the during their sermons. I believe that by doing so, the message of Zero Malaria starts with me will be extended to all communities”. 

Dr Shawa Said, a traditional leader representative from the Kano State Emirate Counsel on Health, KASECCOH (Committee of the traditional institution) said, “we intend to implement the Zero Malaria starts with me through the various committees at the ward, village and state level. We will sensitise the community to change the behaviour and create demand according to their thematic areas. At the ward level which is where the bulk of the work is, data is collected daily which includes neonatal death, maternal health, routine immunization etc. We are going to include the use of mosquito nets and raise awareness of Malaria and how to prevent it. It would be our daily storytelling and data”.  

“I will employ and deploy all my prowess, knowledge, experiences to do the needful. I will propagate the ideals of the meeting through press releases, and using social media” said one of the media representatives, Ibrahim Abdullahi, Public Relations officer, Kano state hospital management board. 

Gabriel O. Enya, one of the religious leaders’ representatives from Sabon gari, noted that the implementation of the outcome of the meeting would help to reduce the spread of Malaria especially among children that are under 5 years of age. “I appreciate the Federal Government and donors for providing the ITNs to Kano residents. I promise to spread the news on the need to sleep inside ITNs as I can imagine the number of people who have died so far from Malaria. I will work with the religious leaders and traditional leaders to ensure the message of Malaria is communicated across every platform”. 

The Zero Malaria start with me campaign stakeholder meeting identified stakeholders across different sectors to ensure a continuous engagement with relevant authorities and promote the key message of “Zero Malaria Start with me” in the eradication of Malaria in Kano state. The campaign which is the first of its kind in Nigeria will be implemented in other states to ensure a malaria free Nation.