In northern Nigeria, a new white paper on the Safety and Antimicrobial Resistance of Mass Administration of Azithromycin (SARMAAN) reports that caregivers are placing growing confidence in the health workers who deliver a life‑saving antibiotic to their homes.
The study, titled “From Trusted Messenger to Understood Medicine” and released in October, shows that trust in frontline workers rose from 37 percent in December 2025 to 84 percent by August 2026. During the same period, the proportion of caregivers who believed the medicine was safe for their children climbed significantly, and most other measures of confidence tracked by the programme improved.
At present, SARMAAN reaches about 16 million children aged one to 59 months across 11 Nigerian states, giving each eligible child an approved dose of azithromycin during distribution rounds.
The evidence for the approach is well established. The MORDOR trial, published in the New England Journal of Medicine in 2018, found that twice‑yearly doses of azithromycin reduced child deaths by 13.5 percent in high‑mortality settings. A later trial in neighbouring Niger recorded a 14 percent reduction among children in the same age group that SARMAAN now serves.
For Nigeria, the stakes are high. The country’s under‑five mortality rate is estimated at about 116 deaths per 1,000 live births, with the North West and North East remaining among the worst‑affected zones.
The report draws on SARMAAN’s Emotional Sentiment Index, a household survey that reached 3,384 caregivers in its latest round, and on interviews with implementing partners Malaria Consortium, Sightsavers and the Solina Centre for International Development and Research. Fathers, who hold strong influence over whether children take part in health programmes, were found to be pivotal; engagement with them, religious leaders and traditional rulers helped shift opinion even in households where men make the final decision.
Other health programmes can learn from SARMAAN’s model. House‑to‑house rounds demonstrate that a trusted frontline worker at the door can achieve more than posters and broadcasts alone. By tracking caregiver sentiment alongside coverage, the programme can spot doubt and respond before it turns into refusal. The same community distributors, local‑language materials and listening tools could carry multiple services to a household in one trusted visit, offering a clear promise for integrated child survival in Nigeria.
<small>Source: The Sun Nigeria — read the original story there.</small>
