Integrating Climate Data into Malaria Supply Chain Planning: Adaptive Strategies for Addressing Seasonal Weather Disruptions in Riverine Rural Areas in Kebbi State, Nigeria

Integrating Climate Data into Malaria Supply Chain Planning: Adaptive Strategies for Addressing Seasonal Weather Disruptions in Riverine Rural Areas in Kebbi State, Nigeria | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Integrating Climate Data into Malaria Supply Chain Planning: Adaptive Strategies for Addressing Seasonal Weather Disruptions in Riverine Rural Areas in Kebbi State, Nigeria MICHAEL AUDU This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7628931/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Malaria remains a critical health issue in Nigeria, particularly in regions like Kebbi State, which faces recurrent flooding and related logistical challenges. Flooding poses significant challenges to malaria treatment delivery in Kebbi State, Nigeria, where frequent environmental disruptions coincide with peak malaria transmission periods. This research examines how specialised supply chain strategies can improve the accessibility and quality of antimalarial commodities—namely, artemisinin-based combination therapies (ACTs) and rapid diagnostic test kits (RDTs)—in flood-prone areas. By aligning flood resilience with logistics principles drawn from malaria supply chain guidelines, this study highlights adaptive storage, transportation, and community-based distribution methods to reduce stockouts and ensure effective malaria control. Findings suggest that decentralized storage, climate-adaptive logistics, and community health worker (CHW) involvement are key to maintaining malaria treatment access during flood disruptions. This approach supports effective malaria control in regions where climate and environmental factors present growing health risks. Climate Analysis and Modeling Malaria Climate Flood Storage climate-adaptive community health worker (CHW) Figures Figure 1 Introduction In regions with high malaria burdens like Nigeria, environmental factors such as seasonal flooding complicate the distribution of critical antimalarial commodities. Kebbi State, a flood-prone area, experiences recurrent seasonal flooding that disrupts access to malaria treatments during peak transmission seasons. These conditions necessitate a supply chain that can withstand and adapt to logistical challenges to maintain reliable access to essential antimalarial products, such as ACTs and RDTs, which require precise handling due to their sensitivity to environmental conditions. This study explores how the unique characteristics of malaria treatment supply chains can be adapted to withstand flood-related disruptions, drawing from established guidelines in malaria supply chain management. Literature Review Previous studies emphasise the role of environmental conditions in influencing malaria prevalence and supply chain efficiency in sub-Saharan Africa. Environmental conditions, particularly climate and seasonal rainfall, play a significant role in sub-Saharan Africa's malaria transmission and supply chain challenges. Numerous studies have demonstrated that malaria transmission rates are strongly influenced by temperature, rainfall, and humidity, which together create ideal breeding conditions for malaria vectors, particularly during flood events. This pattern holds especially true for regions like Kebbi State in Nigeria, where annual flooding amplifies the risk of malaria transmission. According to the World Health Organization (WHO) and the Nigeria National Malaria Control Programme (NMCP), flooding events, by creating large expanses of stagnant water, directly increase mosquito breeding, leading to a surge in malaria incidence in affected areas (WHO, 2022; NMCP, 2021). These findings underscore the critical need for supply chains that are both resilient and responsive to rapid environmental changes and localized health crises. The USAID ATLAS Report on Climate and Malaria Incidence in Malawi (2020) provides specific insights into how climate variability influences malaria incidence in sub-Saharan Africa. By examining the climate-malaria nexus, the report shows that increased rainfall and rising temperatures correlate with higher malaria transmission rates, making climate a predictive factor for malaria outbreaks. This insight is particularly relevant for flood-prone areas like Kebbi State, where frequent flooding not only exacerbates the malaria burden but also disrupts health service delivery. The ATLAS report emphasizes that integrating climate data into malaria control planning can allow for more proactive supply chain responses, ensuring that sufficient stocks of critical commodities like artemisinin-based combination therapies (ACTs) and rapid diagnostic test kits (RDTs) are available when and where they are most needed. These findings suggest that anticipating malaria incidence peaks through climate monitoring could play a crucial role in malaria supply chain management in flood-affected areas. Malaria commodities such as ACTs and RDTs require careful handling due to their specific characteristics, including temperature sensitivity, limited shelf life, and the need for precise stock management. The Guidelines for Managing the Malaria Supply Chain underscore these challenges, noting that ACTs, being particularly vulnerable to temperature fluctuations, require climate-controlled storage and transportation. This is especially important in regions like Kebbi, where flooding can cause severe delays in transportation, resulting in potential stockouts or the degradation of stored products. According to the guidelines, inventory management practices like first-to-expire, first-out (FEFO) should be implemented to prevent wastage, and temperature-sensitive commodities should be stored in resilient, decentralized hubs close to high-incidence areas (USAID & NMCP, 2019). By establishing these climate-resilient storage and handling practices, the supply chain can maintain the integrity of ACTs and RDTs despite logistical disruptions caused by environmental challenges. The WHO and NMCP emphasize that malaria supply chains must be equipped to handle the seasonality and heterogeneity of malaria transmission, particularly in remote and flood-affected regions. Seasonal peaks in malaria cases align with rainy periods when road access to health facilities may be severely restricted due to flooding. The Nigeria Malaria Indicator Survey (2021) reported that logistics infrastructure in rural areas often lacks the flexibility to adapt to these rapid environmental changes, leading to stockouts and compromised malaria control efforts. This report further supports the recommendation from the guidelines that malaria control programs should consider decentralized storage solutions and alternative delivery routes, such as boats or drones, to sustain supply chains under adverse conditions. Such adaptive logistics solutions are crucial to ensuring that health facilities in flood-prone areas have consistent access to malaria treatments and diagnostics during peak transmission seasons (WHO, 2022). A critical component of maintaining effective malaria supply chains in challenging environments is the role of community health workers (CHWs) or Health Facility Workers, particularly in last-mile distribution. The Guidelines for Managing the Malaria Supply Chain suggest that HFWs or CHWs can be trained in basic stock management and diagnostic procedures, allowing them to serve as reliable distributors in flood-isolated communities. This strategy not only extends the reach of malaria treatment but also mitigates the impact of transportation disruptions on treatment accessibility. The USAID report supports this community-based approach, noting that engaging local actors in supply chain operations enhances resilience and ensures that critical health interventions reach underserved populations during environmental crises. Empowering CHWs or HFWs as part of a decentralized supply chain framework thus aligns intending to maintain malaria control even during flood-induced disruptions. Recent advancements in health logistics technologies offer promising solutions for managing supply chains under flood conditions. The ATLAS report discusses the potential of climate-sensitive logistics systems, which incorporate predictive modeling based on real-time climate data to anticipate malaria transmission trends. By deploying early warning systems that use data on rainfall and temperature, health systems in flood-prone areas like Kebbi can trigger pre-emptive resupply efforts and allocate resources more efficiently. Moreover, GPS-enabled tracking and mobile logistics management information systems (LMIS) can improve supply chain visibility, allowing for real-time monitoring of inventory levels and distribution progress even in remote regions. Implementing these systems in malaria supply chains could significantly enhance Kebbi State's ability to maintain malaria treatment supplies during flood seasons, especially when conventional transportation routes are inaccessible (USAID, 2020 ). Integrating climate data into malaria supply chain operations, decentralizing storage, engaging CHWs or HFWs, and utilizing alternative transportation are critical steps for building resilience against climate-induced disruptions in high-burden areas like Kebbi State. Together, these adaptive strategies offer a robust framework for sustaining malaria treatment accessibility and improving health outcomes under challenging environmental conditions, addressing the unique supply chain challenges identified by both the ATLAS report and the malaria supply chain guidelines. Methodology This study employs a mixed-methods approach, combining qualitative interviews with health workers, community leaders, the Malaria Control Unit and the Logistics Management Information Unit (LMCU) in Kebbi State with quantitative data on malaria incidence, stockout rates, and environmental conditions. The research also analyzes logistics management information systems (LMIS) data to assess the frequency and severity of supply chain disruptions during flooding events from 2019 to 2023. Data on flood events were obtained from the National Emergency Management Agency (NEMA) and local health records to establish a correlation between flooding and malaria incidence rates. This analysis aims to identify adaptive supply chain practices that enhance resilience and mitigate disruptions during flood seasons. Yearly Flood Impact in Kebbi State (2019–2023) S/N Year Number of Affected Areas/Communities Description of Impact 1 2019 12 Local Government Areas Thousands displaced, heavy damage to homes and farms due to recurring floods across major regions. 2 2020 10 + Communities Flooding due to heavy rains led to extensive agricultural losses and displacement of residents. 3 2021 12 Local Government Areas Significant flooding affected several thousand people, with damage to homes and infrastructure. 4 2022 Nearly all LGAs, major towns Severe flooding affected over 200,000 people across Kebbi, as intense rains and releases from the Lagdo Dam in Cameroon exacerbated conditions. 5 2023 Primarily in Birnin Kebbi, Dakingari Continued severe flooding, with thousands affected across key towns due to rainfall and insufficient drainage systems. Results Special Handling Requirements and Environmental Impact ACTs and RDTs, due to their sensitivity to temperature and humidity, face storage challenges in flood-prone areas like Kebbi. Floods often disrupt road access and cause storage facilities to become compromised by increased humidity and temperature fluctuations. Findings suggest that decentralized storage hubs equipped with temperature control could prevent degradation of these products during transport delays caused by flooding. Seasonal Peaks and Stock Management Malaria transmission peaks during the rainy season, aligning with flood periods in Kebbi. This seasonal pattern requires proactive quantification and stockpile strategies. Automated LMIS with real-time stock level monitoring were identified as effective in triggering resupply before severe stockouts occur. The system supports targeted pre-positioning of ACTs and RDTs in high-demand areas, mitigating delays caused by transportation disruptions. Community-Based Distribution and Health Worker Engagement Community health workers (CHWs) play a crucial role in reaching remote areas during floods, serving as primary distributors for malaria treatments in isolated communities. The findings indicate that training CHWs in basic logistics, such as stock tracking and ordering, enhances last-mile distribution reliability. Integrating CHWs within the supply chain also ensures that malaria treatments are accessible at the community level, even when conventional logistics channels are blocked by floodwaters. Alternative Transportation and Real-Time Tracking Given that flooding disrupts road access, alternative transport solutions such as drones or boats have proven essential for delivering malaria commodities to isolated areas. Utilizing GPS-enabled tracking allows health facilities and warehouses to monitor shipments in real-time, ensuring that alternative routes are deployed when primary pathways are flooded. This resilience-focused strategy aligns with the guideline’s recommendation for real-time data integration in logistics systems. Discussion The findings suggest that a clim-chain model for malaria control should incorporate decentralised storage, community-based distribution, and flexible transport options. The seasonal nature of malaria incidence, compounded by climate-driven flooding, necessitates proactive inventory management and adaptive logistics. For instance, pre-positioning ACTs and RDTs at local storage hubs before the rainy season can prevent shortages during high transmission periods. Moreover, CHWs or HFWs, trained in diagnostic and logistics practices can serve as reliable distribution points, bridging accessibility gaps caused by floods. The integration of climate data into supply chain management can further improve responsiveness. By correlating historical climate trends with malaria data, health systems in Kebbi can better anticipate demand surges and allocate resources accordingly. Implementing climate-adaptive measures, as recommended by both the Guidelines for Managing the Malaria Supply Chain and USAID and USAID ATLAS Report on Climate and Malaria in Malawi, provides a model for addressing similar challenges across other flood-prone malaria-endemic regions. Conclusion Flooding in Kebbi State has consistently increased the difficulty of maintaining effective malaria control due to environmental damage caused by the floods, creating transportation challenges, and seasonal malaria peaks. Building resilience within the malaria supply chain—through decentralized storage, real-time inventory tracking, and community-based distribution networks—can enhance the accessibility and quality of malaria treatments under adverse conditions. Future research should explore additional applications of alternative transportation and automated systems such as drones to improve health supply chain adaptability in other flood-prone regions of sub-Saharan Africa. Declarations All participants involved in this study provided informed consent before participation. Ethical approval for the study, including the consent process, was obtained from Kebbi State Ministry of Health, which also waived the need for written consent in specific circumstances as per local ethical guidelines. References National Emergency Management Agency (NEMA) and United Nations Development Programme (UNDP) (2023) Flood Impact, Recovery, and Mitigation Assessment for Northern Nigeria National Malaria Control Programme, Nigeria (2021) Nigeria Malaria Indicator Survey USAID (2020) USAID ATLAS Report on Climate and Malaria in Malawi. Analyzes the relationship between climate variability and malaria incidence, providing insights applicable to similar climates in Africa USAID & National Malaria Control Programme (NMCP) (2019) Guidelines for Managing the Malaria Supply Chain. USAID and Nigeria National Malaria Control Programme USAID ATLAS (2020) The Influence of Climate on Malaria Incidence in Malawi. USAID ATLAS Project World Health Organization (2022) World Malaria Report 2022. World Health Organization Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7628931","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":515855131,"identity":"47082bbf-9191-4212-a4f6-30f29db9c105","order_by":0,"name":"MICHAEL AUDU","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYDACZgY2IGkBxAkMBxIMbIAMxsYDRGiRAGlhPPChIA2kpQG/FgaEFuaDMz4cBgvh1aLbzvzswY8KCXmD4zkGh3kMztutbT8MtKXGJhqXFrPDbOaGPWckDDeceQPScjt525lEoJZjabkNOLXwsEnwtkkwbriRA9FidgCohbHhMF4tkn//SdhDtZxLNjv/kLAWad4GiUSQloMzDA7Ymd0gaAubmbTMMYnkmWeeFRz4YJCcYHYDaEsCPr+cP/xM8k2NjW3f8eTNHxL+2NmbnU9/+OBDjQ1OLRggEawygVjlIGBPiuJRMApGwSgYGQAAjS5nzcLrolIAAAAASUVORK5CYII=","orcid":"https://orcid.org/0009-0009-2931-8964","institution":"Independent Researcher","correspondingAuthor":true,"prefix":"","firstName":"MICHAEL","middleName":"","lastName":"AUDU","suffix":""}],"badges":[],"createdAt":"2025-09-16 10:01:07","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7628931/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7628931/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91603790,"identity":"9b5caf8a-1c22-4d3b-8685-3df16783e242","added_by":"auto","created_at":"2025-09-18 09:07:56","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":163124,"visible":true,"origin":"","legend":"\u003cp\u003eLegend not included with this version.\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7628931/v1/3e7877c7e56b59c525528617.jpg"},{"id":91605417,"identity":"05990f1d-6645-4a55-b44d-714bd19baf1a","added_by":"auto","created_at":"2025-09-18 09:16:00","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":480481,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7628931/v1/e6bda8f8-a7ae-46d8-bdc4-d12ba3635ea7.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eIntegrating Climate Data into Malaria Supply Chain Planning: Adaptive Strategies for Addressing Seasonal Weather Disruptions in Riverine Rural Areas in Kebbi State, Nigeria\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn regions with high malaria burdens like Nigeria, environmental factors such as seasonal flooding complicate the distribution of critical antimalarial commodities. Kebbi State, a flood-prone area, experiences recurrent seasonal flooding that disrupts access to malaria treatments during peak transmission seasons. These conditions necessitate a supply chain that can withstand and adapt to logistical challenges to maintain reliable access to essential antimalarial products, such as ACTs and RDTs, which require precise handling due to their sensitivity to environmental conditions. This study explores how the unique characteristics of malaria treatment supply chains can be adapted to withstand flood-related disruptions, drawing from established guidelines in malaria supply chain management.\u003c/p\u003e"},{"header":"Literature Review","content":"\u003cp\u003ePrevious studies emphasise the role of environmental conditions in influencing malaria prevalence and supply chain efficiency in sub-Saharan Africa.\u003c/p\u003e\u003cp\u003eEnvironmental conditions, particularly climate and seasonal rainfall, play a significant role in sub-Saharan Africa's malaria transmission and supply chain challenges. Numerous studies have demonstrated that malaria transmission rates are strongly influenced by temperature, rainfall, and humidity, which together create ideal breeding conditions for malaria vectors, particularly during flood events. This pattern holds especially true for regions like Kebbi State in Nigeria, where annual flooding amplifies the risk of malaria transmission. According to the World Health Organization (WHO) and the Nigeria National Malaria Control Programme (NMCP), flooding events, by creating large expanses of stagnant water, directly increase mosquito breeding, leading to a surge in malaria incidence in affected areas (WHO, 2022; NMCP, 2021). These findings underscore the critical need for supply chains that are both resilient and responsive to rapid environmental changes and localized health crises.\u003c/p\u003e\u003cp\u003eThe USAID ATLAS Report on Climate and Malaria Incidence in Malawi (2020) provides specific insights into how climate variability influences malaria incidence in sub-Saharan Africa. By examining the climate-malaria nexus, the report shows that increased rainfall and rising temperatures correlate with higher malaria transmission rates, making climate a predictive factor for malaria outbreaks. This insight is particularly relevant for flood-prone areas like Kebbi State, where frequent flooding not only exacerbates the malaria burden but also disrupts health service delivery. The ATLAS report emphasizes that integrating climate data into malaria control planning can allow for more proactive supply chain responses, ensuring that sufficient stocks of critical commodities like artemisinin-based combination therapies (ACTs) and rapid diagnostic test kits (RDTs) are available when and where they are most needed. These findings suggest that anticipating malaria incidence peaks through climate monitoring could play a crucial role in malaria supply chain management in flood-affected areas. Malaria commodities such as ACTs and RDTs require careful handling due to their specific characteristics, including temperature sensitivity, limited shelf life, and the need for precise stock management. The Guidelines for Managing the Malaria Supply Chain underscore these challenges, noting that ACTs, being particularly vulnerable to temperature fluctuations, require climate-controlled storage and transportation. This is especially important in regions like Kebbi, where flooding can cause severe delays in transportation, resulting in potential stockouts or the degradation of stored products. According to the guidelines, inventory management practices like first-to-expire, first-out (FEFO) should be implemented to prevent wastage, and temperature-sensitive commodities should be stored in resilient, decentralized hubs close to high-incidence areas (USAID \u0026amp; NMCP, 2019). By establishing these climate-resilient storage and handling practices, the supply chain can maintain the integrity of ACTs and RDTs despite logistical disruptions caused by environmental challenges.\u003c/p\u003e\u003cp\u003eThe WHO and NMCP emphasize that malaria supply chains must be equipped to handle the seasonality and heterogeneity of malaria transmission, particularly in remote and flood-affected regions. Seasonal peaks in malaria cases align with rainy periods when road access to health facilities may be severely restricted due to flooding. The Nigeria Malaria Indicator Survey (2021) reported that logistics infrastructure in rural areas often lacks the flexibility to adapt to these rapid environmental changes, leading to stockouts and compromised malaria control efforts. This report further supports the recommendation from the guidelines that malaria control programs should consider decentralized storage solutions and alternative delivery routes, such as boats or drones, to sustain supply chains under adverse conditions. Such adaptive logistics solutions are crucial to ensuring that health facilities in flood-prone areas have consistent access to malaria treatments and diagnostics during peak transmission seasons (WHO, 2022).\u003c/p\u003e\u003cp\u003eA critical component of maintaining effective malaria supply chains in challenging environments is the role of community health workers (CHWs) or Health Facility Workers, particularly in last-mile distribution. The Guidelines for Managing the Malaria Supply Chain suggest that HFWs or CHWs can be trained in basic stock management and diagnostic procedures, allowing them to serve as reliable distributors in flood-isolated communities. This strategy not only extends the reach of malaria treatment but also mitigates the impact of transportation disruptions on treatment accessibility. The USAID report supports this community-based approach, noting that engaging local actors in supply chain operations enhances resilience and ensures that critical health interventions reach underserved populations during environmental crises. Empowering CHWs or HFWs as part of a decentralized supply chain framework thus aligns intending to maintain malaria control even during flood-induced disruptions.\u003c/p\u003e\u003cp\u003eRecent advancements in health logistics technologies offer promising solutions for managing supply chains under flood conditions. The ATLAS report discusses the potential of climate-sensitive logistics systems, which incorporate predictive modeling based on real-time climate data to anticipate malaria transmission trends. By deploying early warning systems that use data on rainfall and temperature, health systems in flood-prone areas like Kebbi can trigger pre-emptive resupply efforts and allocate resources more efficiently. Moreover, GPS-enabled tracking and mobile logistics management information systems (LMIS) can improve supply chain visibility, allowing for real-time monitoring of inventory levels and distribution progress even in remote regions. Implementing these systems in malaria supply chains could significantly enhance Kebbi State's ability to maintain malaria treatment supplies during flood seasons, especially when conventional transportation routes are inaccessible (USAID, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIntegrating climate data into malaria supply chain operations, decentralizing storage, engaging CHWs or HFWs, and utilizing alternative transportation are critical steps for building resilience against climate-induced disruptions in high-burden areas like Kebbi State. Together, these adaptive strategies offer a robust framework for sustaining malaria treatment accessibility and improving health outcomes under challenging environmental conditions, addressing the unique supply chain challenges identified by both the ATLAS report and the malaria supply chain guidelines.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003cp\u003eThis study employs a mixed-methods approach, combining qualitative interviews with health workers, community leaders, the Malaria Control Unit and the Logistics Management Information Unit (LMCU) in Kebbi State with quantitative data on malaria incidence, stockout rates, and environmental conditions. The research also analyzes logistics management information systems (LMIS) data to assess the frequency and severity of supply chain disruptions during flooding events from 2019 to 2023.\u003c/p\u003e\u003cp\u003eData on flood events were obtained from the National Emergency Management Agency (NEMA) and local health records to establish a correlation between flooding and malaria incidence rates. This analysis aims to identify adaptive supply chain practices that enhance resilience and mitigate disruptions during flood seasons.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eYearly Flood Impact in Kebbi State (2019\u0026ndash;2023)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eS/N\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYear\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNumber of Affected Areas/Communities\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDescription of Impact\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 Local Government Areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eThousands displaced, heavy damage to homes and farms due to recurring floods across major regions.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2020\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u0026thinsp;+\u0026thinsp;Communities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFlooding due to heavy rains led to extensive agricultural losses and displacement of residents.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2021\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 Local Government Areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSignificant flooding affected several thousand people, with damage to homes and infrastructure.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2022\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNearly all LGAs, major towns\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSevere flooding affected over 200,000 people across Kebbi, as intense rains and releases from the Lagdo Dam in Cameroon exacerbated conditions.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2023\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePrimarily in Birnin Kebbi, Dakingari\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eContinued severe flooding, with thousands affected across key towns due to rainfall and insufficient drainage systems.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eSpecial Handling Requirements and Environmental Impact\u003c/p\u003e\u003cp\u003eACTs and RDTs, due to their sensitivity to temperature and humidity, face storage challenges in flood-prone areas like Kebbi. Floods often disrupt road access and cause storage facilities to become compromised by increased humidity and temperature fluctuations. Findings suggest that decentralized storage hubs equipped with temperature control could prevent degradation of these products during transport delays caused by flooding.\u003c/p\u003e\u003cp\u003eSeasonal Peaks and Stock Management\u003c/p\u003e\u003cp\u003eMalaria transmission peaks during the rainy season, aligning with flood periods in Kebbi. This seasonal pattern requires proactive quantification and stockpile strategies. Automated LMIS with real-time stock level monitoring were identified as effective in triggering resupply before severe stockouts occur. The system supports targeted pre-positioning of ACTs and RDTs in high-demand areas, mitigating delays caused by transportation disruptions.\u003c/p\u003e\u003cp\u003eCommunity-Based Distribution and Health Worker Engagement\u003c/p\u003e\u003cp\u003eCommunity health workers (CHWs) play a crucial role in reaching remote areas during floods, serving as primary distributors for malaria treatments in isolated communities. The findings indicate that training CHWs in basic logistics, such as stock tracking and ordering, enhances last-mile distribution reliability. Integrating CHWs within the supply chain also ensures that malaria treatments are accessible at the community level, even when conventional logistics channels are blocked by floodwaters.\u003c/p\u003e\u003cp\u003eAlternative Transportation and Real-Time Tracking\u003c/p\u003e\u003cp\u003eGiven that flooding disrupts road access, alternative transport solutions such as drones or boats have proven essential for delivering malaria commodities to isolated areas. Utilizing GPS-enabled tracking allows health facilities and warehouses to monitor shipments in real-time, ensuring that alternative routes are deployed when primary pathways are flooded. This resilience-focused strategy aligns with the guideline\u0026rsquo;s recommendation for real-time data integration in logistics systems.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings suggest that a clim-chain model for malaria control should incorporate decentralised storage, community-based distribution, and flexible transport options. The seasonal nature of malaria incidence, compounded by climate-driven flooding, necessitates proactive inventory management and adaptive logistics. For instance, pre-positioning ACTs and RDTs at local storage hubs before the rainy season can prevent shortages during high transmission periods. Moreover, CHWs or HFWs, trained in diagnostic and logistics practices can serve as reliable distribution points, bridging accessibility gaps caused by floods.\u003c/p\u003e\u003cp\u003eThe integration of climate data into supply chain management can further improve responsiveness. By correlating historical climate trends with malaria data, health systems in Kebbi can better anticipate demand surges and allocate resources accordingly. Implementing climate-adaptive measures, as recommended by both the Guidelines for Managing the Malaria Supply Chain and USAID and USAID ATLAS Report on Climate and Malaria in Malawi, provides a model for addressing similar challenges across other flood-prone malaria-endemic regions.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eFlooding in Kebbi State has consistently increased the difficulty of maintaining effective malaria control due to environmental damage caused by the floods, creating transportation challenges, and seasonal malaria peaks. Building resilience within the malaria supply chain\u0026mdash;through decentralized storage, real-time inventory tracking, and community-based distribution networks\u0026mdash;can enhance the accessibility and quality of malaria treatments under adverse conditions.\u003c/p\u003e\u003cp\u003eFuture research should explore additional applications of alternative transportation and automated systems such as drones to improve health supply chain adaptability in other flood-prone regions of sub-Saharan Africa.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAll participants involved in this study provided informed consent before participation. Ethical approval for the study, including the consent process, was obtained from Kebbi State Ministry of Health, which also waived the need for written consent in specific circumstances as per local ethical guidelines.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNational Emergency Management Agency (NEMA) and United Nations Development Programme (UNDP) (2023) Flood Impact, Recovery, and Mitigation Assessment for Northern Nigeria\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNational Malaria Control Programme, Nigeria (2021) Nigeria Malaria Indicator Survey\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUSAID (2020) USAID ATLAS Report on Climate and Malaria in Malawi. Analyzes the relationship between climate variability and malaria incidence, providing insights applicable to similar climates in Africa\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUSAID \u0026amp; National Malaria Control Programme (NMCP) (2019) Guidelines for Managing the Malaria Supply Chain. USAID and Nigeria National Malaria Control Programme\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUSAID ATLAS (2020) The Influence of Climate on Malaria Incidence in Malawi. USAID ATLAS Project\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization (2022) World Malaria Report 2022. World Health Organization\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Malaria, Climate, Flood, Storage, climate-adaptive, community health worker (CHW)","lastPublishedDoi":"10.21203/rs.3.rs-7628931/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7628931/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eMalaria remains a critical health issue in Nigeria, particularly in regions like Kebbi State, which faces recurrent flooding and related logistical challenges. Flooding poses significant challenges to malaria treatment delivery in Kebbi State, Nigeria, where frequent environmental disruptions coincide with peak malaria transmission periods. This research examines how specialised supply chain strategies can improve the accessibility and quality of antimalarial commodities\u0026mdash;namely, artemisinin-based combination therapies (ACTs) and rapid diagnostic test kits (RDTs)\u0026mdash;in flood-prone areas. By aligning flood resilience with logistics principles drawn from malaria supply chain guidelines, this study highlights adaptive storage, transportation, and community-based distribution methods to reduce stockouts and ensure effective malaria control. Findings suggest that decentralized storage, climate-adaptive logistics, and community health worker (CHW) involvement are key to maintaining malaria treatment access during flood disruptions. This approach supports effective malaria control in regions where climate and environmental factors present growing health risks.\u003c/p\u003e","manuscriptTitle":"Integrating Climate Data into Malaria Supply Chain Planning: Adaptive Strategies for Addressing Seasonal Weather Disruptions in Riverine Rural Areas in Kebbi State, Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-18 09:07:51","doi":"10.21203/rs.3.rs-7628931/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"668810f9-9ebf-45e1-b72d-9832557996eb","owner":[],"postedDate":"September 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":54801722,"name":"Climate Analysis and Modeling"}],"tags":[],"updatedAt":"2025-09-18T09:07:52+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-18 09:07:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7628931","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7628931","identity":"rs-7628931","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}