Matuba, Mozambique – Stefina Mocuvele looks on as her grandson Nolege plays happily with his siblings. It’s a far cry from his condition three years ago, when a bout of malaria landed the then six-year-old in hospital, 10 kilometers away from their home in Matuba locality in the Chókwè district of Gaza province, Mozambique.

“He spent three days in hospital,” recalls Stefina, 62. “It was a big worry for us. We had to go back and forth, bringing him food and clothes.

“Before they put the nets on the door and window of the house my grandchildren were always sick with malaria,” adds the grandmother of 12. “But thanks to God, with the coming of this project in 2019, not a single child in our house has been sick with malaria.”

Nolege’s family is among the 400 families to benefit from a household screening project in areas where insecticide-treated nets are conventionally used for malaria control. The project is supported by the World Health Organization (WHO).

Household screenin – fitting nets on doors and windows – has been proven effective in warding off indoor resting and biting vectors. It’s a valuable addition to the malaria vector control toolbox, serving as an alternative to indoor residual spraying and reducing dependence on chemical insecticides.

This year, WHO marked World Malaria Day under the theme "Harnessing innovation to reduce the burden of malaria and save lives". The theme reflects the urgent need to scale up innovation and availability of new tools in the fight against malaria, while expanding access to malaria prevention and treatment as part of more resilient health systems.

According to the WHO World Malaria Report 2021, about 95% of the estimated 228 million malaria-related cases and 600 000 deaths last year occurred in the African region. Moreover, 55% of all cases and 50% of deaths globally are attributable to just six countries in the region, including Mozambique.

The Mozambican scientific community played a significant role in the development of a new malaria vaccine, announced in 2021. And thanks to targeted awareness campaigns, the country saw an 11% year-on-year drop in malaria cases from 2020 (more than 11.3 million) to 2021 (10.6 million).

But Mozambique remains in the top four of 11 countries considered high burden to high impact with respect to malaria. Challenges persist in the correct use of mosquito nets and acceptance by the population of indoor residual spraying.

Dr Sónia Trigo, Public Health and Environment Officer and project focal point at WHO Mozambique, notes that prior to the COVID-19 pandemic, the project had been gaining ground in communities like Chókwè.

“It was going well,” she says. “But the pandemic stalled implementation for about a year.”

With this project, Mozambique is replicating a trial from the Gambia. Results from the Mozambique project are expected to significantly improve the evidence base for this intervention.

Thus far, success is apparent in the health of Nolege and his siblings, who have not visited a malaria ward in the three years since the project’s inception. For authorities such as Alexandre Macuvele, a local chief from Matuba, the signs are promising.

“As a leader, I welcome this initiative, because we gain evidence that it works,” he says. “Our youngest children do not suffer from malaria as much as before.

“Although not every household in this locality has participated in the project, some heads of families whose houses were not selected have voluntarily started to improve their own houses with local materials,” he adds.

WHO Mozambique has been supporting the National Malaria Control Programme with collaboration of the Chókwè Health Research and Training Centre and technical support from International Centre of Insect Physiology and Ecology in Kenya AFRO II Project, with funding from the United Nations Environment Programme.