Real-world effectiveness of Seasonal Malaria Chemoprevention (SMC) in high-burden Mozambique: a quasi-experimental evaluation exploiting an interrupted rollout

LSE Principal Investigator: Bryony Simmons
LSE team: Lesong Conteh, Ranjeeta Thomas
Start Date: 15 June 2026
End Date: 14 April 2027
Funder: LSE Health Seed Research Fund
Partners: Malaria Consortium, Mozambique
Region(s): South and Eastern Africa
Countries: Mozambique
Keywords: Quasi-experimental evaluation; Causal inference; Malaria; Mozambique; Health Policy

Malaria remains the leading cause of child death in Mozambique, one of the five worst-affected countries globally. Seasonal Malaria Chemoprevention (SMC), giving children preventive antimalarial drugs during peak transmission months, has strong evidence of effectiveness from trials in West Africa's Sahel region, but far less evidence exists from Southern and Eastern Africa, where SMC was introduced more recently and malaria transmission looks different.

This project uses Mozambique's rollout of SMC as a natural experiment. SMC began in Nampula province in 2022-23 and in Niassa province in 2024-25. In 2024-25, delivery in Nampula was cancelled for reasons unrelated to malaria trends creating a rare opportunity to study not just what happens when SMC is introduced, but what happens when it is withdrawn. Working with Malaria Consortium, the programme's lead implementing partner in Mozambique, this project applies the synthetic control method to national malaria surveillance data. This approach builds a data-driven comparison group to estimate what would have happened without SMC, without relying on assumptions that can undermine simpler before-after comparisons. The team will measure the effect of SMC introduction on malaria cases and deaths in both provinces, and quantify the impact of the Nampula withdrawal.

The findings aim to inform decisions by Mozambique's National Malaria Control Programme, implementing partners, and funders, at a time when several other countries in the region, including Kenya, Uganda, South Sudan, and Madagascar, are making similar decisions about SMC with limited evidence to draw on. The project will also lay the groundwork for a longer-term research partnership with Malaria Consortium, generating a peer-reviewed publication, a policy brief, and a shared agenda for future collaborative work.