PMI Impact Malaria

Seasonal Malaria Chemoprevention


In 2018, more than 272,000 children under five years of age died of malaria. Accounting for 67% of all malaria deaths worldwide, they are the most vulnerable group affected by malaria. 

Seasonal malaria chemoprevention (SMC) is a campaign style public health intervention to prevent and treat malaria infection in young children living in the Sahel region of Africa. SMC involves giving an antimalarial medicine at monthly intervals for a maximum of four months during the rainy season when malaria transmission spikes (from July to October). The goal is to treat any existing infections and maintain protective drug concentrations in the blood throughout a complete transmission season.

In most countries, distribution teams of paired community health workers (CHWs) go door-to-door administering medicine to children under five years of age. Each pair can visit up to about 80 children a day. In some places, including parts of Niger and Mali, distribution teams stand at a fixed point, with children and their caregivers coming to them.

 Many successful SMC programs are built on existing CHW or integrated community case management (iCCM) programs because CHWs are often best placed to identify children who qualify for SMC, distribute medications, and follow-up to ensure adherence. 


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PMI Impact Malaria (IM) currently supports SMC campaigns in Cameroon, Mali, and Niger, and provides technical assistance to Ghana’s campaign. SMC activities supported by IM are in line with WHO guidelines to provide a treatment dose of Sulfadoxine-Pyrimethamine and Amodiaquine (SPAQ) to children between 3 and 59 months of age at monthly intervals during the malaria transmission season. SMC is not recommended for areas where high levels of resistance to SP or AQ have been demonstrated, including the seasonal transmission belt in southern Africa where SP resistance is well documented.


PMI Impact Malaria’s geographic coverage of SMC activities:


PMI Impact Malaria supported Cameroon, Mali, and Niger’s national malaria control programs in achieving these key accomplishments during the 2019 SMC campaigns:

  • Reached about 3.6 million children under five years of age with medicine to prevent malaria during the rainy season.
    • Mali: 725,000 children, 100% of the targeted children
    • Cameroon: 1.6 million children, 95% of the targeted children
    • Niger: 1.3 million children, 95% of the targeted children
  • Trained, supervised, equipped, and paid over 21,600 distributors in the three countries to achieve full coverage of eligible children in all three countries.
  • Developed ways to pay health workers in a transparent and timely manner. In Mali, IM helped establish a mobile money system to pay 4,266 health workers immediately after each SMC cycle, translating to 37,460 mobile money transactions from July to November. In Niger, IM helped achieve complete and timely payment to thousands of health workers by using a microfinance firm to manage payments.
  • Supported the integration of malnutrition screening during the 2019 SMC campaign in Niger, making it possible to detect and refer over 500,000 moderately to severely malnourished children.


Photo Caption: Community health worker Boubacar Traore explains SMC doses to Mariam Diakite, mother of 8-month old twins Awa and Adama, in Niono, Mali during the first cycle of Mali's 2020 SMC campaign. Photo Credit: PMI Impact Malaria Mali

Sources: PMI SMC Technical Area Page, SMC Learning Brief, WHO Malaria Fact Sheet, PMI Impact Malaria Cameroon Page, PMI Impact Malaria Niger Page, PMI Impact Malaria Mali Page