Before 2023, Ekiti’s health system relied on paper-based stock tracking, unpredictable deliveries, and an overburdened central supply system; a perfect recipe for drug shortages. Widespread myths about malaria treatment and distrust in health facilities also compounded the malaria crisis. With little trust in the system, many families turned to self-medication, traditional remedies, or delayed treatment—often until it was very late.
Dr. Tayo Oluwaseun, a public health worker in Omuo-Ekiti, recounts."Mothers would rush in, carrying children burning with fever. Most times we’d run a test, confirm it's malaria, then tell them to go buy drugs from private pharmacies because our shelves are empty. Most of them couldn’t even afford it.”
Malaria thrives in conditions where stagnant water provides breeding grounds for mosquitoes, and gaps in prevention and treatment leave communities vulnerable. In Ekiti State, with an estimated population of 3.6 million in 2022, the long rainy season (April–October) and tropical climate create ideal conditions for malaria transmission. As a result, the state bears one of the highest malaria burdens in Nigeria, with 32.3% of children aged 6 to 59 months affected.
Why does a disease we’ve long known how to prevent still hold so much ground? And more importantly, how do we build a system strong enough to outlast it?
In April 2023, The Ekiti State Government, with funding from the World Bank, initiated the IMPACT project, with Solina serving as a Non-State Actor (NSA) implementing it. The core mandate of the project is to reduce the burden of malaria-related mortality and morbidity through testing, treatment, and social and behavioral change communication (SBCC) for malaria across communities in Ekiti State.
The first six months was dedicated to the project set-up and subsequent months to malaria service delivery.
Through proactive supply chain management, the IMPACT project has transformed malaria commodity availability in Ekiti. By streamlining procurement, integrating real-time tracking, and strengthening last-mile delivery, it ensures that malaria medicines and rapid diagnostic tests (RDTs) consistently reach 203 public health facilities.
The numbers reflect this progress:
✔ 326,842 individuals received malaria tests in 2024 alone, ensuring early and accurate diagnosis.
✔ 257,485 people, including 75,787 children under five, were treated with Artemisinin-Based Combination Therapy (ACTs) to halt malaria progression.
✔ 38,306 doses of Sulfadoxine–pyrimethamine (SP) were provided to pregnant women to prevent malaria, safeguarding mothers and unborn children.
For those facing severe cases, 396 individuals received Artesunate injections as pre-referral treatment, stabilizing them before transfer to higher-level care facilities.
A health worker in Ikere-Ekiti, Mrs. Adeyemi, happily recounts the shift.“Before, we had patients come in, and all we could offer was advice because we had no medicines. Now, we don’t turn anyone away, we have what we need to save lives.”
Community-led Advocacy
Having addressed critical logistical challenges, the next hurdle was restoring public trust in the PHC system—a trust weakened by past drug shortages and inconsistent service delivery. To bridge this gap, the state deployed 354 Ekiti State Health Vanguards, a network of trained community volunteers, bringing malaria care directly to households in even the most remote areas.
These vanguards conduct rapid tests, administer treatment, and educate families on malaria prevention, bridging the gap between healthcare facilities and those who need them most.
Beyond malaria, these vanguards also provide referrals for HIV care and link families to the National Health Insurance Scheme (NHIS), creating a holistic approach to healthcare access, and contributing to the National goal of universal health coverage in the country.
Mrs. Funke Ogunleye, a mother of three, shares her experience.“I used to think malaria was just normal; something every child must go through. But the health vanguards explained how we could prevent it. They even tested my son at home, and he got medicine immediately. I no longer have to wait until my children are very sick before I act.”
But the real victory will come from institutionalizing these changes to sustain impact beyond the project’s lifespan. The Ekiti State Government is already integrating the Health Vanguards into its primary healthcare system, ensuring continued community-driven advocacy. Additionally, investments in supply chain digitization are being explored to prevent future stockouts and inefficiencies.
Malaria is not an unshakable burden. Through collaboration, commitment, and innovation, we are building a system where no child or mother loses their future to a preventable disease.
