The fight against malaria in Nigeria is becoming more targeted, with health authorities increasingly using information from individual states and local government areas to decide where interventions are most needed.
The shift is based on subnational tailoring (SNT), an approach that recognises that malaria does not affect all parts of Nigeria in the same way.
Research by Nigeria Health Watch shows that the approach is helping to shape decisions on malaria interventions, planning and funding.
Nigeria began using SNT in 2019, building on the World Health Organisation’s High Burden to High Impact initiative.
Instead of relying mainly on national averages, the approach considers differences in malaria transmission, poverty, health system capacity, conflict and climate conditions between locations.
“Malaria does not affect every community in Nigeria in the same way,” said Vivianne Ihekweazu, Managing Director of Nigeria Health Watch. “Our response cannot afford to treat it as though it does.”
From data to decisions
One of the key developments came in 2020 with the creation of the National Malaria Data Repository.
The platform brought together information from routine disease surveillance, household surveys, campaign monitoring and partners.
The research says this has given decision-makers a broader picture of where malaria is concentrated and where interventions may have the greatest effect.
The use of local evidence has already influenced several malaria programmes. Seasonal malaria chemoprevention, for example, had expanded to 21 of Nigeria’s 36 states by 2023.
Data from the SNT process has also been used to guide the distribution of insecticide-treated nets in southern Nigeria and identify malaria hotspots for indoor residual spraying.
It has also supported decisions on the rollout of the R21 malaria vaccine in selected states. The research reports that national malaria parasite prevalence dropped from 27 per cent in 2015 to 15 per cent in 2025.
Local evidence also affects funding
The use of subnational evidence is not limited to decisions about where to provide malaria interventions.
According to the research, subnational analysis, intervention planning and costed operational plans have also contributed to negotiations for Global Fund grants and investment decisions by the US President’s Malaria Initiative.
The idea is to ensure that available resources respond to the different malaria burdens and health system needs across Nigeria. But researchers say the approach still faces important obstacles.
Data gaps remain
Some parts of the country’s malaria information system still have gaps, particularly routine surveillance and data from the private health sector.
There are also differences in technical and analytical capacity between locations. Other challenges include unreliable financing, fragmented supply chains and logistical difficulties.
The researchers warn that these issues could affect efforts to sustain subnational tailoring. They recommend that governments make SNT part of their annual health planning and budgeting.
They also call for stronger local capacity to analyse data, improved data quality and greater reliance on evidence when deciding how limited resources should be distributed.
Donors, they say, should also align their funding with priorities identified through SNT.
This could help reduce duplication and ensure that funding reflects differences in malaria burden and health system needs between states.
What happens next?
Nigeria Health Watch is set to bring journalists, researchers and other stakeholders together for a virtual briefing on 18 August 2026, ahead of World Mosquito Day on 20 August.
The session will examine the findings of the research and what is needed to maintain a more targeted approach to malaria control. The briefing will run from 2pm to 3pm WAT.
The research was conducted between 2025 and 2026 by Nigeria Health Watch in collaboration with the Harvard T.H. Chan School of Public Health and Applied Health Analytics for Delivery and Innovation. Northwestern University also contributed to the research.
