Malaria continues to be a major public health challenge, with an estimated 405,000 deaths from malaria in 2018. The most intense malaria transmission occurs in West and Central Africa during and shortly after the rainy season. Seasonal Malaria Chemoprevention (SMC) is a proven strategy developed specifically for these areas, which was first introduced in 2012. Its use was rapidly expanded through the ACCESS-SMC project, which showed that there were marked reductions in the number of malaria cases, severe cases, and deaths in hospital malaria due to malaria, when SMC was introduced.

The drugs (sulfadoxine-pyrimethamine plus amodiaquine, given to children once a month for a few months each year) don’t give complete protection but the benefits are clearly visible, and the strategy has been welcomed by communities. In 2019, 85 million treatments were administered in 13 countries reaching a total of about 22 million children, and this year, SMC programmes are targeting 30 million children.

The challenge now is to ensure that within the areas where SMC is being implemented, it is done effectively, and all children are being reached and are receiving all their monthly treatments.

Very high coverage is possible thorough door to door campaigns, but this is not being achieved everywhere. The reasons vary, and operational research is needed to understand the local challenges and the steps needed to address them. In some areas, four monthly cycles are not enough to cover the high risk period and the number of cycles needs to be increased. There is an urgent need to close these gaps and to optimize SMC delivery to protect all eligible children. The OPT-SMC project aims to contribute to this goal by strengthening capacity of national programmes to conduct implementation research to improve SMC delivery and impact.