Health
SARMAAN reaches 16m Nigerian children with azithromycin
Janet Ogundepo
The Safety and Antimicrobial Resistance of Mass Administration of Azithromycin in Children 1–59 Months in Nigeria programme has reached more than 16 million children across 11 northern states, its organisers have said.
The milestone comes as Nigeria continues to record a slow decline in under-five mortality, with deaths falling from 132 to 102 per 1,000 live births between the 2018 Nigeria Demographic and Health Survey and the 2023–24 NDHS.
However, the current figure remains more than four times the Sustainable Development Goal target of 25 deaths per 1,000 live births, underscoring the need for child-survival interventions that can be delivered effectively at scale.
The SARMAAN programme, which is part of the regional REACH Network, is expected to feature in discussions on equity, inclusion and sustainability at the 18th World Congress on Public Health, to be held in Cape Town from September 6 to 9, 2026.
In a press release sent to PUNCH Healthwise, SARMAAN noted that its experience demonstrates how evidence, government leadership, community engagement, frontline delivery, safety monitoring and scientific evaluation can be combined in large-scale child-survival interventions.
The Lead Investigator of SARMAAN and Director of Research at the Nigerian Institute of Medical Research, Professor Oliver Ezechi, said the programme had demonstrated that safety monitoring and antimicrobial resistance surveillance could be integrated into mass drug administration at scale.
“What the data from SARMAAN shows is that safety monitoring and antimicrobial resistance surveillance can be built directly into a mass drug administration project at scale, not layered on afterwards. The experience demonstrates that rigorous science and large-scale delivery do not have to compete; they can strengthen one another,” Ezechi said.
The project said its reach had been supported by efforts to deliver interventions where children live, while ensuring that caregivers had adequate information and confidence to allow trained personnel into their communities and homes.
The SARMAAN Champion, paediatrician and global health leader, Dr Zainab Shinkafi-Bagudu, stressed the importance of systems that respond effectively to the needs of children.
She said, “Reaching children at this scale requires health workers, caregivers, communities and government systems to work together. True equity is when an intervention can reach all children, regardless of where they live.”
SARMAAN said repeated rounds of implementation had also demonstrated the importance of community participation, noting that communities were not merely recipients of public health interventions but partners in determining their success.
The First Lady of Jigawa State and SARMAAN Champion, Hadiza Namadi, said maintaining community trust was essential to sustaining public health programmes.
“The numbers are important, but behind them are mothers, caregivers and communities who have opened their doors and placed their trust in the people delivering this intervention. Sustaining that trust requires continuous engagement, respect for communities and strong government leadership. That is how public-health programmes become part of the communities they are designed to serve,” she noted.
SARMAAN also highlighted supervised administration, personnel training, safety monitoring, pharmacovigilance and mechanisms for responding to concerns as key components of its implementation.
Paediatrician and SARMAAN Champion, Professor Robinson Wammanda, said the scale of the intervention required a carefully designed delivery system.
“What is important about the SARMAAN experience is the use of multiple platforms to successfully reach these children at this scale,” Wammanda stated.
Meanwhile, SARMAAN noted that through engagement with government stakeholders, it was exploring ways to align the lessons and gains of SARMAAN with broader child-health priorities and existing planning structures.
At the state level, discussions are increasingly focused on how effective child-survival interventions can move beyond project cycles towards greater institutional ownership, appropriate integration and sustainable financing.
SARMAAN further said its experience reinforced the need to ensure that interventions demonstrating impact did not remain temporary successes, but that the evidence generated, systems strengthened, trust built and partnerships created became foundations for lasting change.
It said this would help build health systems where the survival and wellbeing of caregivers and children were secured through strong and sustainable systems.
The SARMAAN Project is an evidence-based child-survival programme designed to accelerate efforts to reduce under-five mortality in high-burden states in Nigeria.
It implements mass drug administration of azithromycin through a government-led, multi-partner approach aimed at ensuring scalability, sustainability and health system strengthening.
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