With storytelling, street-level campaigns and vaccine advocacy, the National Orientation Agency (NOA) is reshaping malaria prevention in the country’s most vulnerable areas, writes GBENGA SALAU

In a country where malaria continues to kill hundreds of thousands each year and rob millions more of good health, the fight against the mosquito-borne scourge has often appeared like a Sisyphean struggle. For the most part, progress has come in fits and starts, hampered by poor access to healthcare, entrenched habits and fragmented public messaging.

But since a little over a year ago, the National Orientation Agency (NOA) has emerged as an unexpected but increasingly crucial player in the country’s fight against malaria. The agency has made malaria prevention a cornerstone of its grassroots communication strategy, rolling out a battery of public awareness campaigns and community-level interventions designed to embed anti-malaria habits in the hearts of everyday Nigerians.

In the South-South and South-West geo-political zones, the NOA’s efforts are helping reframe how the war against malaria is fought, less as a top-down campaign driven by medical elites, but more as a bottom-up movement driven by information and tradition to confront the quiet cruelty of the disease.

For communities in the South-South and South-West zones, the disease is more than a public health issue. It is a generational shadow, woven into the rhythms of daily life. Since late 2023, the NOA has stepped into a more visible and vocal role in Nigeria’s fight against malaria. From Lagos to the oil-rich communities of the Niger Delta and the cocoa belts of Osun, the agency has deployed its grassroots machinery to shift habits, reframe beliefs, and build trust around prevention and treatment. It is a war fought not just against mosquitoes, but against misinformation, neglect and fatalism.

The NOA’s entry into the malaria fight is no random detour. Instead, it reflects a strategic decision to align civic enlightenment with public health behaviour change, especially in zones, where cultural habits and historical underdevelopment often complicate disease prevention.

The South-West, with its mix of cosmopolitan cities and rural backwaters, and the South-South, home to Nigeria’s most waterlogged and malaria-prone terrain, are high on the vulnerability index. The two zones are where the NOA’s Community Orientation and Mobilization Officers (COMOs) have been most active.

The approach has been to strip away the abstraction and make the fight real as well as personal. To make this work, the malaria messages to the doorsteps of the people, without which all the talk about vaccines and treated nets would have meant nothing.

Perhaps no state illustrates this better than Bayelsa, one of the first two states in Nigeria to begin administering the new R21/Matrix-M malaria vaccine in late 2024. With its riverine geography, dispersed population and weak health infrastructure, vaccine rollout in Bayelsa was always going to be complex. But the NOA quickly embedded itself into the planning framework, mobilizing town announcers, religious leaders and school teachers to prepare communities for the vaccine’s arrival.

“Before the first child got the jab, our officers had already explained what the vaccine does, what it doesn’t do, and why it must be combined with other malaria tools. We went to markets, fishing settlements, even houseboats,” said an NOA public enlightenment officer in Yenagoa.

This preemptive strategy paid off. Vaccine hesitancy, common in many parts of Nigeria, was noticeably lower in the Bayelsa communities where NOA had conducted intensive engagement because the people were not just hearing it from the radio, but also from their neighbours, chiefs and their pastors.

In Osun State, where traditional beliefs often compete with scientific prescriptions, the NOA has been tackling another entrenched problem: the misuse of insecticide-treated nets (ITNs).

In collaboration with local government health teams and the National Malaria Elimination Programme (NMEP), the NOA launched a storytelling-based campaign called “Aabo L’ori Alale” (Protection Over the Sleeper), using Yoruba folktales and parables to recast the net as a symbol of family care and foresight. The campaign aired on local radio, featured in school debates and was dramatised in community halls.

In Ondo, another malaria hotspot, the agency leaned on its network of traditional rulers, many of whom have been enlisted as “Malaria Champions.”

One of the most influential voices has been the Deji of Akure, who now includes malaria prevention reminders in his public addresses.

The case of Lagos State presents a different challenge altogether. Here, the enemy is not lack of information but information fatigue. Urban sprawl, mass migration and diverse demographics make sustained behavioural change a herculean task. But the NOA has found ways to cut through the noise.

During the build-up to World Malaria Day 2025, the Lagos NOA office launched a digital campaign tagged #MalariaEndsWithUsLagos, using short animations, influencers, and community WhatsApp groups to push three core messages-the use of nets, elimination of stagnant water and warning against self-medication.

The agency also partnered with the Lagos State Primary Health Care Board to amplify the voices of market women, teachers and artisans in malaria testimonials, featuring short stories of how prevention changed their lives. These were recorded in Yoruba, Egun and Pidgin and aired in bus parks and on neighborhood radio stations.

In Edo State, malaria is both a rural and urban threat. The NOA responded with a hybrid strategy, using digital used for cities like Benin and analogue for riverine and forest communities. One standout initiative was the “Malaria-Free Family Pledge,” a campaign that encouraged households to commit to specific practices such as sleeping under nets, emptying containers, attending ante-natal sessions and avoiding over-the-counter self-treatment. COMOs facilitated family pledge ceremonies in churches and town squares, often combining the message with other civic duties like voter registration and environmental sanitation in a bid to create rituals of responsibility.

In Delta State, a region where oil wealth coexists with severe health disparities, NOA operatives reported increased demand for treated nets following their outreach in Ijaw and Urhobo-speaking communities.

In both South-West and South-South zones, NOA has heavily involved religious and traditional institutions. In Ibadan, the Chief Imam of Oyo State devoted two consecutive Friday sermons to the dangers of untreated malaria. In Akwa Ibom, women fellowship groups in churches became informal hubs for vaccine advocacy.

More than a year into this intensified campaign, the results, while still evolving, are already visible. Net usage rates have risen modestly in surveyed communities in Osun, Ondo, and Edo. Knowledge of the malaria vaccine’s purpose and schedule has improved, especially in Bayelsa and Lagos. Perhaps most importantly, people now talk about malaria not as a seasonal curse, but as a solvable problem.

As Nigeria eyes the ambitious goal of malaria elimination by 2030, the Southern states, long plagued by the disease due to climate, culture and infrastructure will remain critical battlegrounds. NOA’s current momentum offers a glimmer of hope that behavioural change can finally catch up with science.

There are plans to expand the storytelling model used in Osun to other Yoruba-speaking states, and to replicate Bayelsa’s vaccine mobilization blueprint in riverine communities across Rivers and Cross River. In Lagos, new digital dashboards are being developed to monitor community feedback in real-time.