Malaria in Pregnancy: A Persistent Challenge in Nigeria

Malaria remains a significant threat to maternal and child health in Nigeria, despite the availability of effective prevention tools. As the world observes World Malaria Day 2026 under the theme “Driven to End Malaria: Now We Can. Now We Must,” the focus in Nigeria shifts from policy existence to consistent implementation. While frameworks to protect pregnant women are established, gaps in delivery continue to position mothers and babies at risk.

The Burden of Malaria in Pregnancy

In sub-Saharan Africa, an estimated 12.7 million pregnant women are exposed to malaria infection each year. Nigeria bears the largest share of this burden on the continent. The consequences are severe: maternal anaemia, low birth weight, preterm delivery, stillbirth, and neonatal death. A baby born with low birth weight faces a higher risk of dying during the first year of life, and a mother with severe malarial anaemia faces a greater risk of death during delivery.

Malaria infection during pregnancy can also lead to spontaneous miscarriage, particularly in the first trimester. Symptomatic Plasmodium falciparum or P. Vivax infection increases the risk of fetal loss, stillbirth, preterm delivery, and low birth weight due to placental infection. The parasite targets the placenta, disrupting nutrient flow to the fetus and impairing development.

Prevention Tools Are Available but Underutilized

Nigeria has established strategies to prevent malaria during pregnancy, including:

• Integration of preventive treatment into antenatal care (ANC) protocols
• Widespread distribution of insecticide-treated nets (ITNs)
• Public health messaging on malaria prevention

These tools and policy frameworks are in place, but their impact depends on continuity, timing, and consistency. Prevention fails not because the tools are absent, but because delivery is inconsistent across the health system. Each point of contact in antenatal care presents vulnerabilities that can interrupt protection.

Why Consistent Delivery Matters

Available data consistently show where the continuity of malaria interventions breaks down. Even when women attend antenatal clinics, they may not receive the full course of preventive treatment or may not use ITNs regularly. Health system challenges — such as stockouts, staff shortages, or poor follow-up — undermine efforts to sustain protection throughout pregnancy.

As Prof. Wellington Oyibo, Consultant and Medical Parasitologist at the College of Medicine, University of Lagos, emphasized ahead of World Malaria Day 2026: “Untreated malaria remains a top cause of spontaneous miscarriage and maternal complications in Nigeria.” He urged pregnant women to prioritize using insecticide-treated nets, seeking early antenatal care, and undergoing diagnostic testing to safeguard their health, and pregnancies.

The Path Forward

Ending malaria in pregnancy requires more than just having the right policies — it demands reliable execution. Strengthening supply chains, training health workers, improving patient education, and ensuring regular monitoring are essential steps. When prevention is delivered consistently at every antenatal visit, the tools already in place can save lives.

Now we can. Now we must.

Frequently Asked Questions

How does malaria affect pregnancy?

Malaria during pregnancy can cause maternal anaemia, miscarriage, stillbirth, preterm delivery, and low birth weight. The parasite infects the placenta, disrupting nutrient and oxygen supply to the fetus.

What preventive measures are recommended for pregnant women in Nigeria?

Pregnant women should use insecticide-treated nets, attend antenatal care early and regularly, receive preventive treatment as part of ANC, and seek prompt diagnostic testing if they experience symptoms.

Why is consistent delivery of malaria prevention key?

Even with effective tools available, protection depends on receiving interventions at the right time and throughout pregnancy. Gaps in delivery — such as missed doses or inconsistent net use — leave women and babies vulnerable to infection.

What is Nigeria’s share of the malaria burden in pregnancy?

Nigeria accounts for the largest share of malaria in pregnancy cases in sub-Saharan Africa, where an estimated 12.7 million pregnant women are exposed to malaria each year.