Optimizing the role of ‘lead mothers’ in seasonal malaria chemoprevention (SMC) campaigns: formative research in Kano State, northern Nigeria

Abstract

Background Seasonal malaria chemoprevention (SMC) is a safe and effective intervention for preventing malaria in children under 5 years of age. Lead mothers are community health volunteers that help caregivers comply with monthly administration of anti-malarial drugs during SMC campaigns. The lead mother approach is used in several SMC implementing states across Nigeria, but there is lack of evidence about their roles and how effective they are. This study sought to better understand the current role of lead mothers, identify areas for improvement and ways to optimize the role of lead mothers during SMC campaigns. Methods This paper reports the formative phase of a three-phased intervention development study. The formative phase involved semi-structured interviews with stakeholders from national, state, local government and community levels (n = 20). Thematic analysis was used to identify key themes, forming the basis of a subsequent co-design workshop with stakeholders routinely involved in SMC campaigns. Results The findings of the formative phase converged around four overarching themes: skills and attributes required of lead mothers; factors that affect lead mother’s roles; how lead mothers interact with Community Health Influencers Promoters Services (CHIPS) agents and re-imagining the role of lead mothers during SMC campaigns. Conclusion This formative work in Kano state indicates that through their strong connection to communities and unique relationship with caregivers, lead mothers can and do influence caregivers to adopt healthy behaviours during SMC campaigns. However, there is room for improvement in how they are recruited, trained and supervised. There is need to improve lead mothers’ knowledge and skills through adequate training and supporting materials, so they can deliver targeted health messages to caregivers. Sustainability of the lead mother approach is at risk if policymakers do not find a way of transitioning their role into the existing community health worker infrastructure, for example by using CHIPs agents, and ensuring less reliance on external donor support.

Seasonal malaria chemoprevention in Africa and China’s upgraded role as a contributor: a scoping review

“…Search items most mentioned in the research articles’ titles were “development or progress”, “challenge”, “gap or disparity”, and “China and Chinese”, which is shown in Table 1 . Additionally, we found four reports in the Institutional Repository for Information Sharing of WHO [ 7 , 73 – 75 ]. The flow diagram of the research articles selection process is shown in Fig.…”

Prediction of malaria positivity using patients’ demographic and environmental features and clinical symptoms to complement parasitological confirmation before treatment

“…Given the health implications of malaria, Nigeria has joined other African countries to eradicate the disease between 2025-2030 (14). In addition to the Federal Ministry of Health's National Malaria Elimination Programme (NMEP), the President established the "Nigeria End Malaria Council" in August 2022 to reduce the malaria burden in the country and serve as a platform to solicit funds to promote malaria elimination (15); (3); ( 16); (17). Several control measures, including the distribution of long-lasting insecticide-treated mosquito nets, provision of malaria chemoprevention drugs, and utilisation of indoor residual insecticide spray, among other strategies to eradicate malaria, have been implemented by various African governments (18); ( 19); (20); (21); (22).…”

Prediction of malaria outcomes using patients’ demographical, environmental and clinical features

“…Given the health implications of malaria, Nigeria has joined other African countries in committing to eradicating the disease by 2025-2030 (Zawawi et al, 2020). In addition to the Federal Ministry of Health's National Malaria Elimination Programme (NMEP), the President established the "Nigeria End Malaria Council" in August 2022 to reduce the malaria burden in the country and serve as a platform to solicit funds to promote malaria elimination (Sokunbi et al, 2022;Ajayi et al, 2020;Oyeyemi et al, 2020;Okereke et al, 2023).Several control measures, including distributing long-lasting insecticide-treated mosquito nets, providing malaria chemoprevention drugs, and utilising indoor residual insecticide spray, among other strategies to eradicate malaria, have been implemented by various African governments (Sarpong & Bein, 2021;Mohanan et al, 2022;Biset et al, 2022;Namuganga et al, 2021;Asingizwe et al, 2019). However, despite ongoing efforts by the African governments to combat malaria, it remains a significant public health challenge in Africa and continues to affect the continent's population and economy (Oladipo et al, 2022).…”