Burkina Faso’s Batié Health District faces high malaria burdens among children under five, with poor access to health facilities—especially during the rainy season—hindering vaccine delivery. Jhpiego and our partners collaborated with the Ministry of Health to implement seasonal malaria chemoprevention campaigns (SMC) and launch the RTS, S malaria vaccine in 2024. Initial vaccination coverage was low, largely due to geographic barriers and logistical challenges. With our partners, we integrated vaccine catch-up activities into SMC campaigns which led to high vaccine catch-up rates in Batié, with over 97% of identified unvaccinated children receiving doses.
Malaria is a life-threatening disease spread to humans by certain types of mosquitoes. Predominantly found in tropical countries, it affects more than 260 million people around the world, most of whom live in Africa. It is preventable and curable but can be deadly for high-risk populations, especially children. The Sud-Ouest region of Burkina Faso regularly records high burdens of malaria among children under five. In 2024, 258,618 cases of malaria in children were recorded in the region. Contributing to that high number was the Batié Health District in the southernmost corner of the country.
To combat these challenges, Jhpiego worked with partners to conduct seasonal malaria chemoprevention (SMC) campaigns and supervision and awareness drives in partnership with Burkina Faso’s Ministry of Health. As part of this collaboration, Jhpiego helped launch the malaria vaccine through the Ministry’s Expanded Program in Immunizations initiative, which was launched in 2024 to improve the coverage of children vaccinated with the malaria vaccine, known as RTS,S.
Four months after the launch of the malaria vaccine campaign in February, coverage of the first three doses of the vaccine was lower than nationally expected targets. The Batié Health District was no exception. Supervision during the SMC campaigns revealed that the proportion of children who had not received the malaria vaccine remained high and the proportion of children receiving follow-up vaccinations in the health centers after each SMC cycle remained low.
Batié borders Côte d’Ivoire and Ghana and covers seventeen health facilities with 203 villages. More than 80% of these villages are at least 5 kilometers away from a health facility, making access challenging, especially during the rainy season. Mothers of children who need the malaria vaccine often struggle to get to a health facility to help their child receive the proper doses.
“Mothers of children find it difficult to reach the health facility, especially during the rainy season, given the current state of the roads and the distance,” said Batié District Medical Officer, Dr. Roland Konkobo. “This further delays the vaccination of RTS,S-targeted children and results in sub-optimal protection of children against malaria.”
As a community-based program, it became clear that the SMC campaigns themselves were the answer, providing easier access to services and boosting malaria vaccine coverage. Jhpiego began to organize routine outreach activities in every village located more than 5 kilometers from a health facility, helping to vaccinate children who were not up to date with the recommended doses.
Coordination between district health management teams, health providers, community health workers, and community distributors helped ensure children were able to catch-up and receive the malaria vaccine doses they needed to stay healthy. A key component was increasing communication with mothers to ensure their availability on the day of the vaccination campaigns in the villages. The Batié health district began to record good coverage of caught-up children, unlike the other districts that did not use the same approach. During the first cycle, 97.83% of the children identified as being out of date on their vaccines were vaccinated (135 children). This trend continued through the third cycle, with 195 children vaccinated out of 199 (a catch-up rate of 98%).
Sié Hien, a community health worker at the Kosso health facility, played an important role in this strategy. “I looked for children in need of the RTS,S vaccine and checked their records to see if they were up to date with their malaria vaccination during the SMC+ campaign. Any child who was not up to date was referred to me. I informed the EPI manager at the health facility, and he came to our village to vaccinate the children.”
In addition to improving malaria vaccination coverage, this systematic strategy of vaccinating children who are not up to date reduces the suffering of mothers who once had to travel long distances to vaccinate their children.
“The vaccination session in our village enabled me to benefit from the malaria vaccine for my child,” said Parfeline Somé, the mother of a child eligible for RTS,S who was not up to date. “It was a relief for me. Otherwise, I’d have to wait for the vaccination people to come every month, with the risk of seeing my child reach six months without benefiting from the first dose of RTS,S. From now on, I’ll follow the advice of the health workers to best protect my child by respecting the vaccination schedule, having him sleep under an insecticide-treated mosquito net, and keeping our living surroundings clean.”
This article was reviewed by Dr. Gladys Tetteh, Jhpiego’s Senior Technical Director for Malaria.
Yacouba Bélem is a Malaria Technical Advisor in Burkina Faso, Souleymane Zaré is a Communications Officer in Burkina Faso, and Issa Ouédraogo is a Social and Behavior Change Technical Advisor in Burkina Faso.