Operational Review of the National Malaria Elimination Programme Interventions in Kwara State, North Central Nigeria: Challenges and Progress

The Nigerian National Malaria Elimination Programme represents the country's strategic framework for reducing malaria-related morbidity and mortality, yet implementation at the sub-national level varies considerably across states due to governance, financing, and logistical constraints. This study conducts an operational review of NMEP interventions in Kwara State, North Central Nigeria. A programme evaluation using a mixed-methods design was conducted, covering the 2020 to 2024 implementation period. Document review of state malaria programme reports, DHIS2 data sets, commodity distribution records, and WHO-supported supervision reports provided quantitative programme data. Key stakeholder interviews were conducted with the State Malaria Elimination Programme Coordinator, Local Government Area malaria focal persons, facility heads, and community leaders from 10 purposively selected local government areas. Programme indicators assessed included bednet distribution coverage, IPTp3 uptake, confirmed case rates, and health worker training completion. This review identifies key operational bottlenecks including irregular commodity supply, health worker attrition, inadequate supervision systems, and funding gaps in state government counterpart contributions. Findings will be presented to the Kwara State Ministry of Health, NMEP Federal Headquarters, and implementing partners including the US President's Malaria Initiative for programmatic recalibration. Keywords: malaria elimination programme, operational review, Kwara State, programme management, programme challenges.