Malaria vaccine cuts costs, crowds and caregiver fatigue in Nigeria’s Kebbi State
Nigeria’s new malaria vaccine shows early promise in Kebbi State, delivering both a significant reduction in childhood cases, as well as relief for health workers and families alike.
- 15 August 2025
- 5 min read
- by Adnan Ahmad
The day begins before sunrise for Dr Muawiya Sa’idu, Officer-in-Charge at Birnin Yari Primary Healthcare Centre in the Jega Local Government Area of Kebbi, known as Nigeria’s most malaria-plagued state.
By 7:00, a queue has formed: mothers clutching feverish toddlers, fathers hoping to be seen quickly before heading to the farm, and caregivers carrying mosquito-bitten children on their backs. “Some of the children are already convulsing from severe malaria fevers,” Sa’idu says.
Health workers conduct a rapid triage. Children with high fevers, convulsions, or signs of severe malaria are prioritised. Temperatures are taken, symptoms are logged and malaria rapid diagnostic tests (RDTs) are administered.
A significant number of under-five children test positive. About year ago, that figure averaged about 30 on a daily basis, Sa’idu explains. Health workers dispense artemisinin-based combination therapy (ACT) for uncomplicated cases. For severe cases, artesunate injections or referrals to a higher-level facility are required. They carefully explain dosages to caregivers, emphasising the need to complete the treatment even if symptoms subside.
For clinic staff, managing 30 malaria cases in children day by day can be extremely demanding – both physically and emotionally. “Each child requires close monitoring, especially in severe cases, and ensuring they complete treatment properly is crucial,” Dr Sa’idu explains. “Beyond administering medication, we also spend time educating caregivers, tracking follow-up visits [for outpatients], and sometimes making home visits when parents can’t bring their children to the clinic.” When the cases come in clusters, he adds, it stretches already limited staff and resources.
Signs of improvement
But at Birnin Yagi PHC, hopes that the October 2024 introduction of the malaria vaccine in the state – and its official routinisation in December 2024 – would ease the overwhelm are being encouraged by early signs of change.
Today, Dr Saidu says, facility records show the daily malaria diagnoses stand at around 15 to 17 – a little more than half of the norm a year ago. What’s more, fewer of them belong to that most vulnerable demographic: children under five.
Although the vaccine is relatively new and some children are yet to complete all four scheduled doses, Dr Sa’idu says that morbidity and mortality rates are already appearing to decline, creating more capacity to treat other childhood illnesses, “like other fevers that are not related to malaria, infections and seasonal outbreaks.
“Our stress levels now are bearable unlike before and staff are more available, whereby at any time we are able to respond to outpatients on time,” he adds.
Rasheeda, a local mother whose baby has so far received two of the four recommended doses of the vaccine, shares that her child used to suffer frequent bouts of malaria before getting the jab. “Sometimes we treated at home through traditional methods; other times when we could afford medical treatment we came to the clinic,” she notes.
“My children and other children who have received the doses have gotten better,” Rasheeda says. “We are really grateful for the intervention.”
More than lives saved
Malaria is a leading public health challenge in many communities across Nigeria, which last year accounted for 26% of global malaria cases and 31% of related deaths, according to the 2024 World Malaria Report.
Experts hope the malaria vaccine will spare families not only grief, but also financial stress. In Nigeria, the average cost of treating an uncomplicated case of malaria in an government hospital’s outpatient department falls between 750 Naira and 2,300 Naira (approximately US$ 0.50 to US$ 1.50).
In 2021, a study of two secondary hospitals reported an average direct medical cost of 2,235 Naira (about US $1.80) per case. But the cost of treatment has risen since 2021, driven by the economic downturn and the devaluation of the Nigerian currency. Data from private hospitals found outpatient treatment averaging 3,941 Naira (US$ 2.57).
Severe malaria can incur much higher costs, depending on hospitalisation duration and complexity. Across Africa, severe malaria treatment in children ranged from US$ 15.60 to over US$ 137.80 depending on the setting.
For the vast majority of Nigerians, those are unaffordable costs. According to the most recent household survey conducted in 2018/2019 by the Nigeria’s National Bureau of Statistics (NBS), 30.9% of Nigerians were living below the international poverty line of $2.15 per person per day. This was prior to the COVID-19 pandemic disruptions. According to a World Bank report published in April 2025, since the 2018/2019 survey, an estimated 42 million additional Nigerians have fallen into poverty.
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Vaccination pace picks up
But for the vaccine to have the impact policymakers and health leaders hope that it will, it needs to be taken up widely. Immunisation officer Hadiza Abdullahi Ladan told VaccinesWork that the vaccine initially met a mixed reception, explaining that the unfamiliar jab initially raised many questions, especially why it was targeted only at children under five, and not extended to adolescents or adults.
According to Hadiza, there was resistance in the community: “In a day we used to vaccinate only about five, or at most, ten in a day. My colleagues and I had to show them that we were also vaccinating our children to prove that it is safe,” she said.
Encouragingly, the campaign has since picked up pace. “Now they come in numbers. We enlightened them, and now they know the importance. Even yesterday we received about 40 children.”
She, however, noted that more work needs to be done – especially in hard-to-reach areas where access has been relatively tougher for her and her colleagues.
Other prevention mechanisms
While the arrival of the malaria vaccine in Nigeria is cause for optimism, the jab is not enough on its own to guarantee every child’s safety. Dr Sa’idu explained that health workers continue to conduct health talks to ensure families consistently use Long-Lasting Insecticidal Nets (LLINs) and take advantage of Seasonal Malaria Chemoprevention (SMC).
