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Malaria Care Seeking Saves Rural Health Facility by Health Communication Capacity Collaborative on Exposure
Prompt care seeking at the onset of fever is an important behavior in a community trying to combat the scourge of malaria. An ideal location for care seeking, especially in rural areas, is the nearest primary healthcare center (PHC). But in one rural area of Nigeria, where the malaria burden is among the nation’s highest, a PHC was close to being shut down because of low demand for its services. With a population of 3.2 million, Kebbi state has one of the highest malaria burdens in all of Nigeria and historically low utilization of malaria prevention and control interventions. According to the 2015 Nigeria Malaria Indicator Survey (NMIS), Kebbi has the highest rate of children under five with malaria (64 percent) in the entire nation. It also has among the lowest rates of antenatal attendance among pregnant women (71 percent had no antenatal care at all, 2013 DHS) and low use of intermittent preventive treatment of malaria in pregnancy (5 percent in 2013 DHS; not reported by state in preliminary 2015 NMIS). Only 38 percent of the people in Kebbi said they slept under an insecticide-treated net the night before in the 2015 MIS Survey, although this is an improvement when compared with 19 percent in the 2013 DHS. So closing down a PHC in this high-burden area was not an option, yet demand for services was historically low at the facility in Kimba, which is located in the Jega Local Government Area (LGA) of Kebbi state. Because of low demand, anti-malarial drugs at the Kimba PHC were always nearing their expiration dates, so were being shipped out to other facilities to avoid allowing them to expire on the shelf.