SMC Initiation in Bauchi State, Nigeria: 2-Year Implementation Feedback

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Malaria Consortium in Nigeria participated in the KOICA-funded SMC IMPACT project to implement SMC in Bauchi State, covering 2 LGAs. The objective was to expand SMC coverage and impact in the Sahel region. Successful implementation led to treating over 2 million children aged 3-59 months in 2021-2022 through door-to-door cycles. Year 1 outcomes showed high coverage rates, and Year 2 saw continued success and improvements in community-level implementers.

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SMC Initiation in Bauchi State Nigeria, Feedback and Outcomes from 2 Years Implementation In 2 Districts (Local Government Areas) Chibuzo Oguoma Malaria Consortium Nigeria SMC Alliance Annual Meeting, Conakry - 1 March, 2023 Event name / date

Background SMC was first implemented in Bauchi state, Nigeria, in 2020, in 10 of the 20 Local Government Areas (LGAs). This left a gap of 10 LGAs without SMC coverage in Bauchi State. Malaria Consortium participates in the Korea International Cooperation Agency (KOICA) funded SMC IMPACT project for SMC implementation in 2 of those LGAs Ningi and Tafawa Balewa. The objective of the project is to increase the geographic expansion of SMC and increase impact in the Sahel region of Africa. The funding support is to deliver a total of 2,196,860 treatments to children aged 3 59 months over the period January 2021 December 2022 Two rounds of SMC have been successfully implemented in the two target LGAs of Bauchi State in 2021 and 2022. The SMC rollout was through the door-to-door approach and 4 cycles were implemented in 2020 2021 and 5 cycles in 2022.

Map of Nigeria Highlighting Bauchi State and Projecting the 2 KOICA Funded LGAs

Year 1 2021 Support and Outcomes in the SMC IMPACT LGAs Indicator (2021) Ningi LGA Tafawa Balewa LGA Total Target No. Children 177,107 87,776 264,883 No. (%) Children Reached 181,705 (>100%) 90,200 (>100%) 271,905 (>100%) No. (%) Male Children 93,396 (51.4%) 46,363 (51.4%) 139,759 (51.4%) No. (%) Female Children 88,309 (48.6%) 43,837 (48.6%) 132,147 (48.6%) End of Cycle HH Survey (1 3): End of Round Survey (state-wide) No. Community Level Implementers: Community Distributors Lead Mothers Town Announcers 74% - 63% 85% - 94% 85 94% 94.5% N/A N/A 1,340 159 159 686 90 90 2,026 249 249 Source: Admin Coverage, EoC 1 3 HH Survey & EoR Coverage Survey 2021

Year 2 2022 Support and Outcomes in the SMC IMPACT LGAs Indicator (2022) Ningi LGA Tafawa Balewa LGA Total Target No. Children 189,825 93,114 282,939 No. (%) Children Reached 195,796 (>100%) 95,528 (>100%) 291,324 (>100%) No. (%) Male Children 100,639 (51.4%) 49,197 (51.5%) 149,836 (51.4%) No. (%) Female Children 95,157 (48.6%) 46,331 (48.5%) 141,488 (48.6%) End of Cycle HH Survey (1 4) End of Round Survey (state-wide) No. Community Level Implementers: Community Distributors Lead Mothers Town Announcers 81% - 99% 88% - 95% 81 99% 99.3% N/A N/A 1,428 172 172 730 93 93 2,158 265 265 Source: Admin Coverage, EoC 1 4 HH Survey & EoR Coverage Survey 2022

SMC Implementation in SMC IMPACT LGAs

Malaria incidence in the SMC IMPACT LGAs 2021-22 Fig 2: Incidence of Malaria During Peak Transmission Period, June - October 2020 - 2022 (U5 Age Children) Fig 1: Annual Incidence of Malaria in Target LGAs, 2020 - 2022 (Under 5 Age Children) 25,000 35,000 31,419 30,000 20,000 19,115 24,268 24,019 25,000 15,741 21,389 15,000 14,083 20,000 12,863 9,973 9,830 15,000 10,000 10,000 5,000 5,000 0 - Ningi (U5) Tafawa Balewa (U5) Ningi (U5) Tafawa Balewa (U5) 2021 2022 2020 2021 2022 Source: National Health Management Information System, FMoH Abuja

Conclusion The support from KOICA through the SMC IMPACT project achieved the objectives of expanding geographic coverage and also, impacting on the incidence of malaria in the supported area. The incidence of malaria reduced from 2020 when Ningi and Tafawa Balewa LGAs were not covered by SMC, with: an overall 16.8% reduction in both LGAs from 2020 to 2022 annual incidence, with 11.1% reduction for Ningi LGA and 17.0% for Tafawa Balewa LGA; and an overall 34.9% reduction for both LGAs when restricted to the peak transmissions season (June October) of 2020 and 2022; with an 18.3% reduction in Ningi LGA and 48.6% reduction in Tafawa Balewa LGA.