ITNs &Surveys Bill Brieger | 16 Apr 2025 07:56 pm
Malaria Indicators and the Fate of the Demographic and Health Surveys
The Demographic and Health Survey Program (DHS) has been a mainstay for tracking malaria indicators in endemic countries over the past three decades. When visiting the website now, one is met with the following message, “Due to the on-going review of US foreign assistance programs, The DHS Program is currently on pause. We are unable to respond to any data or other requests at this time. We ask for your patience.” Surveys completed and published before the end of 2024 are still available to view and download, but work that wan is progress has halted.
The example of Nigeria is instructive. One finds a table on the Nigeria Country page that summarizes 25 national level health and development indicators from 1990 to 2021 using either the DHS or the Malaria Indicator Survey (MIS). A 2024 DHS survey was undertaken and a preliminary report is available, but the final detailed report was not written before the transition in administrations.
The 1990-2021 summary table included one malaria variable, children under five years of age sleeping under an insecticide-treated net the night prior to the study. Out of interest the information is posted in a chart herein. Of note, no bednet data were available for 1990. fortunately the 2024 preliminary MIS includes this.
Of note is the coverage in the context of earlier targets of 80% in 2010 and subsequent efforts to cover all children as time passed. The chart shows a slow start reaching only 29% of children by 2010 and then dropping to 17% in 2013. over the next four surveys, the coverage rate hovered in the mid 40% range topping 50% only once.
The Nigeria National Malaria Control Program changed its name some time ago to National Malaria Elimination Program in hopes that this new moniker might lead to improved efforts. Unfortunately this was not to be the case. The value of the DHS/MIS was that countries could easily see progress and challenges and plan accordingly.
The Federal Ministry of Health, Nigeria, in collaboration with the National Population Commission (NPC) have been the local implementers of these surveys over the years. In addition to USAID, other partners such as WHO, UNFPA, The Bill & Melinda Gates Foundation, and the Global Fund have provided assistance in conducting the surveys.
Hopefully Nigeria (and other countries) and various partners will continue to see value in obtaining national and sub-national health and development statistics that document progress and help plan the future efforts to rid endemic populations of malaria and other scourges.