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A public health programme focused on administering azithromycin to children in high-mortality communities has reached 15.76 million unique children across 10 northern Nigerian states between 2024 and 2026.
The Safety and Antimicrobial Resistance of Mass Administration of Azithromycin in Nigeria (SARMAAN) project provides supervised doses of azithromycin to children aged one to 59 months as part of periodic mass drug-administration campaigns.
According to figures from the programme, more than 26 million doses were delivered during the period.
In the first quarter of 2026 alone, over 7.2 million children were reached across Kano, Bauchi, Jigawa and Kaduna states.
The programme operates through health workers and state health structures, with community leaders involved in mobilising households and supporting the delivery of the intervention.
The initiative comes against the backdrop of Nigeria’s high child mortality rate. The 2023–24 Nigeria Demographic and Health Survey estimated under-five mortality at 110 deaths per 1,000 live births.
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Although the figure represents a decline from 201 deaths per 1,000 live births recorded in 2003, it remains significantly higher than the Sustainable Development Goal target of fewer than 25 deaths per 1,000 live births by 2030.
Research associated with the programme has also examined factors influencing caregivers’ acceptance of mass drug administration, including concerns about safety, rumours, household decision-making and understanding of the purpose of free medicines.
The findings indicate that willingness to participate does not always translate into strong confidence in the intervention, highlighting the importance of communication between health workers and caregivers.
The experience of the programme also underscores the logistical challenges involved in reaching children across communities, including planning routes, transporting medicines, coordinating health teams and documenting visits.
Public health experts are expected to discuss issues around health equity, inclusion and sustainability at the 18th World Congress on Public Health, holding in Cape Town, South Africa, from September 6 to 9.
Beyond mass drug administration, health authorities continue to rely on interventions including vaccination, improved nutrition, access to clean water and sanitation, malaria prevention and timely treatment of childhood illnesses to reduce child mortality.
