Access to Routine Insecticide-Treated Nets (rITNs) for Women and Children in Ogun State, Nigeria: The Impact of Dwindling Donor Funding

Access to Routine Insecticide-Treated Nets (rITNs) for Women and Children in Ogun State, Nigeria: The Impact of Dwindling Donor FundingIfijeh F.O ¹ ; Bravo O ¹ ; Oyeneye E.O ² ; Biaghere P.O ³ Background : Access to routine insecticide-treated nets (rITNs) is a cornerstone of malaria prevention for women and children in sub-Saharan Africa, who face heightened risks due to pregnancy and underdeveloped immunity. In Ogun State, Nigeria, rITNs are primarily distributed through antenatal care and immunization services, with availability dependent on donor-funded supply chains. Sustained access is critical for reducing malaria transmission and achieving national and global elimination targets. Methods : A desk review of malaria data from the Nigeria Health Logistics Management Information System (NHLMIS) was conducted, covering January 2023 to May 2025. The review focused on 321 Global Fund-supported health facilities across all 20 local government areas in Ogun State. Results : Findings showed an average rITN availability rate of 74% and order fulfillment rate of 82% during the two-year period, indicating the effectiveness of donor-supported distribution systems. However, by May 2025, availability fell to 59% while order fulfillment rate dropped to 31% in over half of the facilities, following a significant reduction in U.S. financial commitments to the Global Fund. The U.S. has historically contributed approximately one-third of Global Fund resources. A scaling back of its support has ripple effects, particularly in countries like Nigeria, where over 60% of malaria elimination interventions depend on donor financing. This reduction directly disrupted procurement and delivery processes. This situation has exposed vulnerabilities in health system resilience and underscores the dangers of over-reliance on external funding ⁴ . Conclusions : The decline in rITN availability threatens to reverse gains in malaria elimination and increase preventable illness and mortality, particularly among high-risk groups. To ensure sustainability, Nigeria must prioritize domestic resource mobilization, such as state-level malaria trust funds, strengthen last-mile distribution through community-based models and establish public-private partnerships with local manufacturers and logistics providers.