In her home nestled near a mosquito-infested stream in Chirimba Township in Blantyre, Dorothy Kachulu cradles her son on her lap, her gaze fixed on the hazy horizon.
The 10-month-old son, wrapped in a chitenje, plays while his mother’s thoughts are weighed down with frustration.
She has made three trips to Chirimba Primary School, the designated local distribution centre for insecticide-treated nets (ITN), hoping to secure one—each time returning empty-handed.
“We were told the nets would be here by November 11, but when we got there, there was nothing,” Kachulu recounts.
“We were told to return on the 18th, then the 25th. Still no nets.”
Kachulu, who earns a meagre K1 500 a day by selling fritters, has walked two kilometres in the scorching sun each time, only to be turned away.
Her story is one among many exposing logistical failures in the Ministry of Health’s mass distribution campaign for ITNs launched last month.
The programme was expected to conclude by November after distributing 11 million nets to achieve universal coverage.
Funded by a $50 million (K85 billion) Global Fund grant, the initiative is designed to benefit 19 million Malawians, prioritising vulnerable groups such as pregnant women and children.
Malaria remains a significant public health challenge in Malawi, with health authorities recording an estimated 6.2 million cases annually.
The disease is a leading cause of morbidity and mortality across all age groups, accounting for 30 percent of outpatient visits.
Children under-five, like Kachulu’s son, are the most vulnerable.
“I lie awake every night, trying to keep mosquitoes off my child,” she laments. “Without a net, I’m defenceless. I keep hoping the government will come through for us.”
Blantyre director of health and social services Gift Kalawazira on Wednesday confirmed that residents are yet to get the nets.
“The delay is due to logistical challenges at the Ministry of Health and we are waiting for guidance from them,” he said.
Nsanje, a district frequently affected by malaria due to perennial flooding, is yet to get the mosquito nets.
District director of health and social services Gilbert Chapweteka confirmed the delay in a brief response to a questionnaire, stating: “We have an allocation, but the distribution has not been conducted.”
His Mangochi counterpart Henry Chibowa, however, said the nets were distributed, but referred further inquiries to the Ministry of Health.
Ministry of Health spokesperson Adrian Chikumbe said the nets distribution was suspended nationwide due to financial transaction challenges resulting in health workers boycotting the programme.
“The donor partner already gave us funding, but we have a problem with the bank that we used. Its system was down for over a month.
“This affected our operations because some of the health workers said they could not continue until they are paid,” he said in an interview on Friday.
Chikumbe acknowledged that the disruption would hinder the country’s bid to eliminate malaria.
National Malaria Strategic Plan 2023-2030 aims to eliminate malaria as a public health concern by 2030.
“It is worrisome that the campaign had not gone according to our plan. We were supposed to have finalised distribution by now,” he said.
Chikumbe could not immediately disclose how many of the targeted 11 million people have received the nets.
Through the malaria strategic plan, the country seeks to increase the proportion of the general population who use ITNs consistently from 55 to 80 percent by 2030.
Another of the seven interventions aims to increase the proportion of caregivers seeking appropriate malaria treatment for under-five children within 24 hours of fever onset from 46 to 90 percent by 2030.
The National Malaria Control Programme is on record to have said it would receive $82 million on behalf of the ministry from Global Fund to implement malaria control interventions.
From the trench, $50 million would be allocated to the mass net distribution exercise.
Launching the initiative in Balaka, Deputy Minister of Health Halima Daud said malaria remains a huge health problem in Malawi.
“In 2023, 6.4 million cases were recorded with a total of 1 670 deaths,” she said.
Daud added that the disease contributed to 25 percent of all out-patient attendance, 10 percent of all admissions and 12 percent of deaths.
Meanwhile,Parliamentary Committee on Health chairperson Mathews Ngwale said to eliminate malaria, the government needs to invest more than just relying on donors.
He said if the country had a backup plan, it could have paid the health workers and proceeded with the initiative when the ministry was unable to access donor funding.
