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How Nandi County is fighting Malaria through free mosquito nets

Special focus has also been placed on vulnerable pregnant women.

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by STAR REPORTER

Realtime27 November 2024 - 14:45
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In Summary


  • The Kenya Malaria Indicator Survey 2020 showed malaria prevalence in Nandi at 1 per cent.
  • Malaria prevalence rate is higher in Aldai and Tinderet Subcounties at three and four per cent respectively.


Dr. David Bungei, Director Health Services, Nandi County during an interview at his office in Kapsabet/Handout


Nandi County is Kenya’s athletics hub. It is home to tens of the world’s celebrated athletes, including world record breakers such as Pamela Jelimo, Janet Jepkosgei and the legendary athlete Kipchoge Keino.

The county, which is also renowned for its thriving tea estates, is endowed with a beautiful topography that mainly consists of the scenic Nandi Hills.

It is located in the Rift Valley and borders Uasin Gishu County to the North and East, Kericho County to the South East, Kisumu County to the South, Vihiga County to the South West, and Kakamega County to the West.

The County is divided into six constituencies which double as Subcounties namely; Mosop, Emgwen, Chesumei, Nandi Hills, Aldai and Tinderet.

Despite its athletics prowess and breathtaking scenery, it is not immune to the deadly malaria disease.

Dr David Bungei, Director Health Services, Nandi County during an interview at his office in Kapsabet/ Handout

Malaria prevalence

The Kenya Malaria Indicator Survey 2020 showed malaria prevalence in Nandi at 1 per cent.

According to Nandi County Director Health Services David Bungei, the malaria prevalence rate is higher in Aldai and Tinderet Subcounties at three and four per cent respectively.

Bungei has attributed this to the proximity of the two subcounties to malaria-endemic zones of Nyanza region.

"The malaria incidence however varies according to seasonal climatical changes where high incidences occur following heavy rainfall patterns usually around May to July of every year," Bungei explained during an interview in his office at the county's headquarters in Kapsabet.

The county has a cool wet climate with two rainy seasons; the long rains between March and June, and the short rains between October and November.

The rainfall varies between 1,200 mm and 2,000 mm annually, with temperatures of between 15 degrees Celsius and 25 degrees Celsius.

According to Bungei, 6,922 cases of malaria were reported in the county in the month of May.

This followed the heavy rainy season the region and country at large witnessed in the months of March and April.

Confirmed malaria cases in Nandi County/STAR INFOGRAPHICS

Despite this burden, the county has been in the race to defeat the diseases. 

“Dealing with Malaria needs collaboration from various partners.  Malaria has several dynamics and different levels of interventions. There is prevention, we have treatment and also taking care of the needs of those who get sick,” Bungei said.

One of the partners actively involved in fighting malaria in Kenya, including Nandi County, is the Kenya Medical Supplies Authority (Kemsa).

The agency has been distributing insecticide-treated mosquito nets with funding from the Global Fund.

The programme targets 22 counties that are prone to mosquitoes, including Rift Valley, Nyanza and Coast.

This distribution is part of a broader campaign by Kemsa aimed at distributing 10.9 million nets across counties where the disease continues to pose a serious health threat.

The Global Fund programme, implemented under the Malaria Control Programme (NMCP), in collaboration with the President’s Malaria Initiative, aims at distributing treated nets to 22 malaria-endemic counties.

“Nandi has problem of highlands Malaria, with sub counties bordering Kisumu county worst affected because they are low lands and malaria endemic,” Bungei said.

In these regions, malaria prevalence can go as high as 15 per cent; significantly higher than the county's average of 2 per cent.

Bungei says that through interventions such as distribution of the insecticide-treated mosquito nets, the number of malaria cases has gone down compared to 5 years ago.


Patrick Kenei, a nurse at Potopoto dispensary in Tinderet Subcounty in Nandi stands next to bales of treatment mosquito nets/ Handout

Net distribution process

The process started with trainings and community sensitisation. 

Among those trained included those in charge of public health at the community level as well as community health promoters.

The second stage was household registration through a digital platform, to ensure accountability.

Only those registered and details well captured through the platform eventually received the nets.

Once the registration is verified and the data submitted to Kemsa, the mosquito nets are delivered to local distribution points.

Bungei emphasised the importance of community engagement.

“Simply distributing the nets is not enough, people need to be educated on how to use them properly,” he said.

Awareness campaigns are ongoing to educate the public on the importance of sleeping under a treated mosquito net and the long-term benefits it provides.

Additionally, there was an emphasis on understanding the collective effort required to tackle malaria.

The county made it clear that these nets, which were provided for free, represented a significant investment of resources from the government and other partners, and the community’s responsibility was to use them properly.

Special focus has also been placed on pregnant women, who are particularly vulnerable to malaria.

Bungei highlighted a targeted programme that educates expectant mothers on the dangers of malaria and ensures they are given preventive medicine at every clinic visit.

“Here, we educate them about the dangers of malaria, the importance of sleeping under treated mosquito nets, and every time one visits any of the public health facilities for clinic, we give her a preventive medicine,” Bungei said.

“We are also educating communities on draining stagnant water and clearing bushes among other measures to reduce cases of malaria.”

While the digital system for distributing nets has been successful in ensuring accountability and efficiency, there have been challenges.

Delays in receiving One-Time Passwords (OTPs) for some community members caused temporary setbacks.

Despite these challenges, the community’s reception of the initiative has been overwhelmingly positive.

“We have not won the war yet, but we are reducing the numbers. It is possible to prevent malaria, and we are moving in the right direction. Where we were in 2014, patient cases were double what they are today,” said Bungei.

Tinderet Subcounty

The Tinderet Subcounty malaria control coordinator Samuel Rotich explained that 83,930 mosquito nets were being distributed to a population of 156,690 people in the subcounty.  

The total population in the Subcounty, according to Rotich, is 156,690. 

The malaria endemic subcounty has 73 distribution posts for the nets. According to him, the target was two treated nets per family of 4.

In Tinderet Subcounty, the number of confirmed malaria cases dropped from 1,294 to 242 in October.

This is a significant milestone considering that the area had 907 cases in October 2023.

The malaria precedence has risen to 35 from 34.2 in 2023.

In February 2024, the cases were 1,539, with 1,280 cases in March and 962 cases in April.

In May, the confirmed malaria cases were 2,856, in June they were 2,261 and 1,026 in July.

In August, the confirmed cases were 920 and rose to 1,470 cases in September.

Trends in Malaria deaths/STAR INFOGRAPHICS

At local facilities like Potopoto Dispensary, health officials in collaboration with other government agencies are busy undertaking initiatives aimed at addressing the malaria problem.

Patrick Kenei, a nurse at Potopoto Dispensary in Tinderet says women and children are the most affected when it comes to malaria cases.  

Kenei explained that at the facility, malaria cases are high.

“We receive 30 to 50 patients per day.  Out of this, 15 to 20 will be malaria cases.  Per month, we receive 200 to 500 cases of malaria. I can say the biggest health challenge in this area is malaria,” Kenei said.

He said apart from net distribution, the facility has given much attention to educating the community on clearing bushes and ensuring there is no stagnant water.

He says pregnant women are also being given malaria preventive medicine each time they come to the clinic.

“We expect malaria cases to drop, if not to end. We have ensured each person who registered for the net has received it. If you did not register and receive the confirmation message, you cannot be given,” Kenei explained.

“The use of digital platforms ensured accountability. The last net distribution of net here was in 2021 and it was manual. There was a lot of paperwork but this time round, it is easier,” he added.

Kenei said the focus has also been on educating those who are receiving the nets to understand how to use them effectively and also to ensure no net is used for a different purpose.

Aldai Subcounty Malaria Coordinator Geoffrey Lubwa/Handout

Aldai Subcounty

Aldai Subcounty is the other region in Nandi County identified as Malaria endemic.

Aldai Subcounty malaria coordinator Geoffrey Lubwa attributes this to the fact that it borders endemic-prone areas of Nyanza as well as Vihiga with high  movement of people mostly because of trade.

In Aldai Subcounty, cases reported in October were 14 from 1,279 in January.

The 2024 malaria prevalence is 29.3 while that of 2023 was 31.1.

In Aldai, the confirmed cases of malaria cases were 1,127 in February, in March 1,150, in April 1,233, and in May 2,649.

The number decreased to 1,981 in June, 1,766 in July, 1,080 in August and 1,250 in September.

Similar to Tinderet, the subcounty has focused on the distribution of the free nets and proper education of the locals on their proper usage.

According to him, out of the population of 215,000 in the subcounty, 80 per cent registered for the nets and are in the process of receiving them. 

Lubwa explained that Community Health Promoters go around in the villages to educate the locals.

The health promoters are also on the lookout for pregnant women.

“In case they come across one, and the woman has not been to a clinic, that person is referred to a clinic where she will be attended to, given malaria prevention medicine and also a net,” Lubwa explained.

He explained that due to concerted efforts, cases of malaria in the subcounty have gone down compared to 5years ago.



Jackline Cherotich, Clinical officer and Facility Incharge at Kobujoi Health Centre training a patient on usage of treated mosquito net, Aldai Nandi County/ Handout


Irene Chepchirchir, a pregnant woman in one of the facilities in Tinderet confirmed receiving nets from the hospital.

"I have been getting malaria prevention drugs every time I come for clinics here.  I have a net at home that  I was given here. They also taught me how to properly use it,” Chepchirchir said.

The mother of four and who at the time of the interview was four months pregnant, said cases of malaria in her household are now a thing of the past, thanks to partners like Kemsa and Global Fund.

According to the Global Fund Results report on Malaria 2024, the new dual-insecticide mosquito nets insecticide-treated mosquito nets are a cornerstone of malaria control.

“Their widespread use has been instrumental in the dramatic decline in global malaria incidence,” the report reads in part.

But they have historically relied on a single class of insecticides, called pyrethroids.

Over the past two decades, mosquitoes have developed increasing resistance to pyrethroids, reducing the nets’ performance.

To tackle this challenge, the report says the Global Fund has been investing in the rollout and scale-up of the dual active ingredient (dual AI) insecticide-treated mosquito nets.

These nets combine two different classes of insecticides to ensure that mosquitoes resistant to one type are still killed by the second.

“These cost-effective and impactful new nets which can reduce malaria cases by an estimated 45 per cent relative to other net types are absolutely key to getting back on track in the fight against malaria,” the report says.


Trends in Malaria cases/STAR INFOGRAPHICS

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