Evolution of the performance of the malaria control program in Burkina Faso: analysis from 2020 to 2024

Introduction: Malaria remains a public health problem in Burkina Faso, causing harm to the population. Despite significant progress, its elimination remains a major challenge. The objective of this study was to evaluate the performance of the National Program for Malaria Control (PNLP) from 2020 to 2024. Methods An ecological approach, based on secondary data time series from the PNLP, was used. National data from 2020 to 2024 were analyzed to assess the evolution of coverage, the availability and use of interventions, the incidence of malaria. A projection of the impact up to 2030 was carried out by modeling TBATS (Trigonometric, Box-Cox transformation, ARMA errors, Trend and Seasonal components). The analysis, based on the theory of change, examined the link between the implementation of interventions and their epidemiological impact. Results In 2024, long-lasting insecticide-treated mosquito nets (LLINs) covered 75.27% of pregnant women and 81.02% of children under 5 years old, while seasonal malaria chemoprevention (SMC) reached 94.00%. The use of rapid diagnostic tests (RDTs) and artemisinin-based therapeutic combinations (ACTs) were 98.5% and 97.96%, respectively. These interventions reduced the incidence of malaria from 537.5 to 446.4 cases per 1,000 inhabitants. However, supply chain disruptions and insufficient input use limit the overall impact. Projections estimate the incidence to reach 79.31 cases per 1,000 inhabitants in the first quarter and 187.82 cases in the fourth quarter in 2030. Conclusion Despite significant progress, the elimination of malaria by 2030 remains uncertain. Sustainable supply chain strengthening, improved effective use of interventions and integrated governance supported by multi-sectoral coordination are still essential to transform gains into a sustainable health impact.