Siaya's Bold Fight Against Malaria
Despite decades of progress, malaria cases continue to rise globally. A child dies from malaria nearly every minute.
According to the World Malaria Report 2023, there were 263 million cases of malaria in 2023, up from 252 million the previous year. Africa remains the most affected continent, accounting for 94% of all malaria cases and 95% of related deaths. In Kenya, malaria is a persistent public health challenge, contributing to 13% to 15% of all outpatient consultations.
The disease is endemic in 14 counties, including Siaya located in western Kenya on the shores of Lake Victoria, where climate conditions, economic hardship, and limited access to healthcare continue to fuel transmission. However, there is hope. In Siaya, local communities, healthcare workers, and government officials are uniting in the battle against this deadly disease.
Towards a Malaria-Free Kenya: Strengthening Primary Healthcare
In partnership with GSK, Amref Health Africa and the Siaya County Government are strengthening primary healthcare systems to improve malaria diagnostics, treatment, and surveillance through the Primary Health Care for Malaria Elimination project. These efforts complement the work of the Kenyan government through the National Malaria Control Programme, which is dedicated to achieving a malaria-free Kenya.
The county’s approach demonstrates that primary healthcare and community-driven solutions are vital to malaria control.
Malaria vaccine and community action
In October 2023, the World Health Organisation (WHO) recommended a second malaria vaccine, R21/Matrix-M, to complement the RTS,S/AS01 vaccine. This breakthrough is crucial for countries like Kenya, where vaccine availability plays a pivotal role in the fight against malaria.
In Ugenya sub-county, Siaya, malaria vaccine coverage for children under five has surged from 48% to 75%. Rose Yogo, Community Health Services Coordinator for Ugenya, explains, “Before the vaccine, we weren’t doing well. We focused on other preventive measures such as using treated mosquito nets, fumigation, and testing at the community level, but now we have an additional solution.”
Nurse Rosemary Awandu, based at Sega Dispensary, (pictured right administering a malaria vaccine to an infant) has witnessed the positive effects of the malaria vaccine firsthand. “I ensure children get all their routine vaccinations, including malaria, to boost their immunity and prevent the disease,” she says. “We provide health education to mothers so they understand the importance of vaccination. We also do catch-up vaccinations during outreaches. Since we started administering the malaria vaccine, we’ve noticed a decrease in malaria cases among children. Parents have attested that their children hardly get malaria anymore.”
Empowering grassroots action
At the heart of Ugenya’s malaria response are Community Health Promoters (CHPs), local volunteers who educate communities, test and treat uncomplicated malaria, and refer pregnant women to healthcare facilities. Salome Adongo, a CHP who serves over 140 households in Kondiek Community Unit, highlights the importance of community-based care: “When we test and treat children under five at the community level, it reduces the number of patients going to the hospital. We also conduct outreach and hold community sensitisation dialogues, but the frequency of outreach depends on the availability of funding. Distance and a lack of health commodities remain significant challenges.”
Women, who are often the primary caregivers, are especially vulnerable to malaria. The disease also poses significant risks to pregnant women, contributing to maternal anaemia, stillbirths, and low birth weight. By referring pregnant women for timely Intermittent Preventive Treatment in pregnancy (IPTP), CHPs like Salome play a critical role in preventing complications and improving maternal and infant health.
"Data shows that malaria poses severe risks to pregnant women, which is why our CHPs are trained to refer expectant mothers for care," explains Rabin Awandu, Nursing Officer and Medical Superintendent at Urenga Sub-County Hospital. "Their efforts have been instrumental in reducing the burden of malaria."
Data-Driven Malaria Control: A Smarter Approach
Siaya County’s approach to malaria control goes beyond vaccines and community case management; it also incorporates data to inform decision-making. The county’s health management team tracks malaria hotspots and tailors interventions based on local transmission patterns. “We are not just testing and treating; we are using data to make informed decisions and strategies,” says Rabin Awandu.
To ensure the accuracy of malaria tests conducted by CHPs, regular monthly review meetings are held, where refresher training is provided and all referrals are managed. “They have helped reduce the burden of malaria by managing uncomplicated cases at home, offering health education, and following up on patients,” Rabin adds.
To reinforce accountability, CHPs are also required to bring their medical supplies to these review meetings. At each session, they verify the number of malaria tests conducted and drugs administered against the supplies received. This process ensures transparency and enables health facilities to monitor stock levels, preventing shortages of essential commodities and ensuring uninterrupted treatment.
This data-driven approach allows the county to focus resources on high-risk populations and strengthen antenatal and maternal services where malaria poses a significant threat. By targeting specific communities and using evidence-based strategies, Siaya is setting the stage for a malaria-free future.
Furthermore, while targeting communities, there is an emphasis on equity in innovation, ensuring that solutions are developed with and for the affected populations. Siaya’s approach reflects this model, demonstrating that community ownership is central to malaria control.
A model for the path ahead
As global malaria cases continue to rise and international development aid continues to shrink, Siaya’s efforts provide a model for other regions to follow. With continued investment in grassroots health systems, a malaria-free Kenya—and eventually, a malaria-free Africa—could be within reach.
Images above were all taken in Siaya County, Kenya in April 2025 (c) Amref Health Africa/Kennedy Musyoka
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Find out more about the Primary Healthcare for Malaria Elimination project, currently being implemented in Siaya and Busia Counties in Kenya and three target districts in Zambia.
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