How Malaria is stealing pregnancies in Siaya

The silence in Jotham Odundo’s home in Migiro village, Siaya County, is loud with grief. Three pregnancies lost, one after another have shattered a dream of raising a large family. Today, that dream feels so distant and uncertain. His wife, Nancy Achieng, is no longer by his side. 

The emotional toll following the loss has forced her back to her parents’ home, seeking comfort after months of heartbreak. What makes their story even more devastating is the cause of the loss — malaria, a common disease that is both preventable and treatable.

In November 2024, the couple celebrated when Achieng conceived. But the joy was short lived after she developed persistent headaches, fever and abdominal pain, only to loose the pregnancy to malaria at three months. Yet again, in March last year, the 26-year old mother suffered malaria that lead to loss of her three and half months pregnancy.

Still determined, the couple tried once more earlier this year. But sadly, history would repeat itself. At barely three months of pregnancy, she fell ill, was rushed to hospital where he was diagnosed with malaria, only to suffer stillbirth after being put on treatment. Each loss came before she enrolled for Antenatal Clinic (ANC). 

Mosquito net

“Losing three pregnancies pains me deeply. My wife sleeps under a treated mosquito net. We spray the house.

‘‘What more can I do to protect her? poses Odundo, a fisherman.

The repeated tragedies have taken a psychological toll to his wife.

“My wife is stressed more. The losses have made her think she is bewitched or carries a bad omen. Doctors’ explanation linking the stillbirths to malaria do not make sense to her,” says Odundo. 

The couple has been married for seven years, and blessed with two children, a number Odundo want to increase to eight.

Their sad story resonates with the agony of several others, as the World Malaria Day is marked today.

A few kilometres away in Gem, Victoria Odero is quietly battling the pain of a previous pregnancy loss, determined not to relive the same tragedy. 

Now at five months pregnant, she regularly attends ANC, a lesson learned the hard way.

Odero recounts to The Saturday Standard how her third pregnancy ended in heartbreak after she developed malaria, but chose to self-medicate instead of seeking hospital care. 

Sadly while going about her house chores, she started bleeding, and lost the 23 weeks pregnancy.

Pill fatigue has been an issue for Odero, who avoided taking sulphadoxine-pyrimethamine (SP) drugs that prevents malaria in pregnancy.

“I knew malaria kills, but did not know it could trigger pregnancy loss. At the moment, I am walking pregnancy journey with a doctor and sleeping under treated mosquito net,” says the mother of four.

The two encounters mirror a wider national crisis where thousands of women silently battle stillbirths, coupled with deaths linked to malaria as Kenya joins the world to mark World Malaria Day. 

Adverse outcomes

In high malaria burden counties, reports by World Health Organisation and Lancet links malaria in pregnancy to a significant share of adverse outcomes including 27 per cent stillbirths, 33 perc ent miscarriage, and 35 per cent of preterm births. 

Data from the Ministry of Health shows that seven out of 10 stillbirths in malaria-endemic counties are attributed to preventable conditions.

Malaria ranks among the leading causes of death, alongside HIV, maternal hypertension, and syphilis.

The incidences are higher in Siaya, a leading malaria endemic county where at least two per cent of stillbirths are directly linked to severe malaria. 

Though Siaya County Malaria Coordinator Joseph Ogutu acknowledges malaria trigger stillbirth, he maintains that its data remains scantly because it occurs before majority of women enroll for ANC.

Ogutu explains that malaria in pregnancy according to the official risks the life of a mother and baby, as the parasites can accumulate in the placenta, interfering with the supply of oxygen and nutrients to the unborn baby.

This can lead to complications such as severe anaemia in the mother, low birth weight, or, in the worst cases, stillbirth.

“Malaria in pregnancy weakens a woman’s immune system, risking stillbirth, and death of mothers. Sadly, when stillbirth occur, they are rarely reported because the community associates it with witchcraft,” says Ogutu. 

To prevent such outcomes, pregnant women are routinely given SP, commonly known as Fansidar, during ANC visits, as an intermittent malaria preventive treatment.

New infections

The medication helps clear existing malaria parasites and prevents new infections during pregnancy.

Pregnant women and children below one year are also provided with treated Long Lasting Insecticidal nets (LLN), to prevent them from being bitten by malaria transmitting mosquitoes.

Other interventions include indoor residual spraying structures are sprayed inside the house to repel mosquitoes.

Ogutu notes that malaria vaccine, RTS,S administered in four doses at seven, nine, 18 and 24 months of age is also a game changer in the elimination of malaria in the county in under fives.

The jab was introduced in eight endemic counties in Kenya, with support from World Health Organisation, Gavi the Vaccine Alliance and United Nations Children’s Fund (UNICEF).

Ogutu further acknowledges efforts of CHPs in elimination of the disease.

CHPs equipped with malaria testing kits and antimalarials, walk to households to conduct malaria tests ,while referring to adverse cases to hospital for care.

Additionally, Amref Health Africa has in the past stepped up efforts to eliminate malaria in Kenya through a targeted primary healthcare initiative focused on some of the country’s hardest-hit regions.

Working in collaboration with the National Malaria Programme, Amref is implementing the Primary Healthcare for Malaria Elimination Project, an initiative aimed at strengthening health systems to improve the diagnosis, treatment, prevention, and surveillance of malaria cases.

The project is currently being rolled out in Siaya and Busia counties.

In Siaya, the interventions are ongoing in Gem, Alego, Usonga, Ugunja and Ugenya sub-counties, while in neighbouring Busia, where malaria cases and deaths rank among the highest nationally, the project covers Teso Central, Teso North, Bunyala and Butula.

Healthcare systems

Dennis Kinyua, the manager of the Primary Healthcare for Malaria Elimination Project at Amref Health Africa in Kenya, notes that the initiative is anchored on strengthening primary healthcare systems to ensure communities receive timely and effective malaria services.

“The main objective of the programme is to enhance prevention, diagnosis and treatment of malaria by building the capacity of healthcare workers,” Kinyua says in an interview.

He explains that the project places a strong emphasis on training frontline health workers, including community health promoters, equipping them with the knowledge and skills needed to tackle malaria at the grass roots level.

Through these efforts, the programme aims to empower health workers to address the challenges faced by communities, ultimately contributing to the reduction of malaria cases and deaths in the targeted counties.

The Rotary Club has also been working closer with communities to eliminate malaria in high burden counties. 

For example, the club has established school health clubs in Western Kenya, including Siaya, Kisumu, Lugari, Busia, Bungoma, and Kakamega, targeting school-age children who are heavily affected by malaria.
The school-based programmes support pupils through health clubs that explain malaria prevention and how malaria affects them.

The programme, supported by a Rotary International global grant, integrates health education into school programs and uses games, storytelling, and community activities to help children remember the impacts of malaria in a fun, practical, and relatable way.

Rose Waringa, Rotary Western Region Director, notes that “public health education begins at an early age by engaging children as health champions, who become powerful messengers of change within their families, schools, and communities.”

“There is need to fight malaria through different approaches and be consistent about it, because for example, if we distribute mosquito nets, not every home has a bed to fix it,” observes Waringa.

The club also facilitates training of healthcare workers and CHPs, on diagnostics, treatment and prevention of malaria.  

Though prevention measures has helped reduce malaria cases in endemic counties, more efforts more so financial he acknowledges that more work is still needed to reduce indicators, more so in Siaya. 

However, with efforts put in place to end the endemic by 2030, as per Kenya’s targets, experts warn that funding gap is likely to reverse gains made in elimination of the disease. 

Even as this year’s World Malaria Day theme, “Driven to end malaria: Now we can. Now we must”, sounds confident, the disease kills at least 10,700 people annually, with 4.2 million new infections reported in 2024. 

Siaya, Vihiga, Migori, Kakamega and Busia counties are clustered as very high burden counties. In Siaya for example, malaria burden stands at 562.1 per 1,000 population, to mean out of two people, at least one has malaria.

The malaria programme was heavily funded by the US, through Presidential Malaria Program and USAID, support that has been cut following signing of stop work order by President Donald Trump.

Ogutu notes that the funding gap has adversely affected commodity supply. For example, Siaya is running out of LLN mosquito nets,

 Even with a drop in funding Siaya has allocated only Sh1 million for malaria program, an increase from Sh300,000, in previous years.

Total budgetary allocation for health in the county is Sh2.1 billion. The county Director Public Health Sanitation and Health Planning Kennedy Odhiambo notes the allocation if for coordination, advocacy and resource mobilisation.

The official admits that “malaria is a threat to lives and requires more financial investments.

Not enough

“County budgetary allocation is not enough. For example, an amount required to manage a single malaria patient is about Sh14,000. The county allocation cannot meet this,” says Odhiambo.

Previously, malaria programmes including diagnosis, treatment, and purchase and distribution of mosquito nets was fully donor supported. A drop in funding has seen the Siaya report stock outs of mosquito nets, facida and malaria testing kits.

Since 2007, US government has invested more than $ 500 million (Sh65 billion) to diagnostics, bed nets, and spraying campaigns in Kenya.

With exit of USAID funding, the Kenyan government is seeking a corporation framework, aimed at shifting to support long-term

A spot check across respective hospitals in the county, and malaria endemic counties reveals an acute shortage of LLN. Pregnant women are told to wait for mosquito nets, whose supply is not guaranted. Unfortunately, the nets are not available in shops as they are donor funded. CHPs are also reporting stock out of malaria testing kits.

Joan Anyango Lale, regrets to delayed testing of a 17-year-old Form Three student at Kandaria Secondary School after he presented with symptoms of malaria. Lale, a CHP at Adunyo Kokisa, in Rarieda vividly recalls receiving a phone call to test Evans Odhiambo, who complained of persistent headache, nausea and fatigue. She referred the student to Abidha Health Center. At the facility, he was diagnosed with adverse malaria, only for her to die two days after being put on treatment.

“This deaths saddens so much as a CHP. Perhaps I could have saved the student’s life, had I tested and referred him on time,” Lale regrets.

Odhiambo’s death has shut the world for his mother, Beatrice Owino. The deceased, was her second born, and only son.

“This death is painful. Just three days of sickness- joint pains, headache and fatigue, and my son was no more,” says Awino.

Odhiambo rode himself to hospital on February 28, and died on March 2, 2026, and later buried on March 18, 2026.

Fishermen in the county, are also reported to bear high burden of the disease, as they spend more hours in water bodies, breeding zone for mosquitoes.

The Standard on Saturday meets a section of fishermen at the shores of Mageta Island, mourning their colleague David Owuor who just died of malaria. Owuor is alleged to have complained of joint pain, while fishing before collapsing. He was rushed to Mageta Health Center, and later referred to Bondo, where he died of malaria.

Wakawaka Beach Management Unit, chairman Erick Adede Oginga, regrets that had Owuor received care on time, his life could have been saved. The health centre did not have malaria diagnostics. Fishermen he adds are not supplied with mosquito nets, despite being predisposed to malaria bites. 

“NGOs used to supply fishermen with mosquito nets, but currently, there is none. We wear long sleeved shorts, to keep mosquitoes at bay, but they still bite our faces, transmitting us with malaria,” regrets Oginga. 

The stock-outs of mosquito nets at Mageta Health Centre. Only pregnant women are given mosquito nets, whose supply is not constant. At the facility malaria is a leading disease, recording 80 percent of the cases, with fishermen topping the list of patients. The hospital serves four islands namely Mageta, Magare (part of neighbouring Uganda), Sifu and Hama. 

“There’s a problem with supply of nets. When we’ve nets, we do mass distribution because of high demand. But with fishermen, they go fishing at night, a time when mosquitoes are more active,” says the hospital nurse in charge Daningtone Oyambo.