Sustainability of state malaria control programmes in Nigeria : looking beyond donor support

Abstract

The objectives of this study were to 1) identify success factors of malaria control, 2) assess financing alternatives, and 3) formulate alternative funding strategies for sustaining malaria control programmes in four Nigerian States of Adamawa, Gombe, Kano and Zamfara due to their high maternal and child mortality and morbidity figures. Quantitative data were collected through reviews of reports on malaria morbidity and mortality in the states. Qualitative data were collected using focus group discussion and in-depth interviews. The main factors found to be behind the success of the state malaria control programmes included the provision of long lasting insecticidal treated nets, free distribution of ACTs and SPs, Indoor Residual Spray, building the capacity of health workers and community awareness and involvement in mobilization and enlightenment for malaria control. Strategies based on the needs, priorities and resource availability for the different states are suggested as alternatives for sustaining malaria control. These include exploring partnerships with the private sector especially for states with high economic activities. This can take the form of local production of treated nets and malaria drugs through subsidy policy from the government and tax relief. Other strategies include involving the communities to contribute to malaria control through trainings, community health insurance schemes and participation in distribution of drugs and nets; vigorous resource mobilization; strengthening of environmental management policies and ensure strong surveillance systems especially in states with international borders. All these may provide windows of opportunity for making malaria programmes sustainable even in the absence of donor support.