Geospatial Prioritization and Cost-Effective Delivery of Seasonal Malaria Chemoprevention for Under-Five Children in Sokoto State, Nigeria

Authors

Yakubu Joel Cherima, Usman Muhammad Ibrahim, Zubairul Islam, Kebiru Umoru, Onigah Peter Oko, Chioma Victoria Udumah, Charles Adeiza Umar, Yonwul Jacqueline Dakyen

Abstract

Seasonal malaria chemoprevention (SMC) is a highly effective intervention for reducing malaria morbidity and mortality among children under five years of age in the Sahel; however, its implementation is constrained by geographic inaccessibility, dispersed settlements, and limited healthcare infrastructure. This study developed an integrated geospatial framework for ward-level operational planning and costing of malaria chemoprevention in Sokoto State, Nigeria. Household microcensus data, GRID3 settlements, WorldPop population estimates, malaria surveillance records, health facility locations, OpenStreetMap road networks, travel-time indicators, and malaria transmission metrics were integrated to quantify chemoprevention priority, operational deprivation, delivery modality, and program costs. A total of 244 wards and 10,592 settlements comprising 762,317 children under five years of age were evaluated. The chemoprevention priority index exhibited substantial spatial heterogeneity, with high-priority wards concentrated in Gada, Sabon Birni, Isa, Tangaza, and Wurno. The mean travel time to the nearest health facility ranged from less than 5 min to 163.2 min, while the number of health facilities per ward varied from 0 to 15. Fixed-session delivery was recommended for 76.2% of children, outreach services for 14.6%, mobile teams for 6.9%, and temporary nodal centers for 1.5%. The estimated programme cost was USD 1.10 million per SMC cycle and USD 4.39 million annually, with annual LGA costs ranging from approximately USD 45,000 to USD 346,561. The findings demonstrate that malaria chemoprevention needs and delivery costs are highly location specific and that geospatially targeted operational strategies can improve the efficiency, equity, and financial prioritization of malaria interventions in high-burden settings.

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