By Imam Wali:
In Chipande Village, under Senior Chief Kamenyagwaza in Dedza District, a free, insecticide-treated mosquito net stretches across a backyard’s vegetable patch. It serves as a makeshift fence, keeping roaming chickens away from vegetables.
A few kilometres away, at Dedza District Hospital, five-year-old Fatsani Matenje fights for her life in the children’s ward.
This stark disconnect is killing children across Dedza District.
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While some citizens convert life-saving medical resources into garden fencing and groundnut-drying sheets, households skipped during mass distribution campaigns are left entirely defenceless against a preventable, deadly disease.
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This misuse and distribution gaps are driving preventable deaths, despite over K23 billion being spent on nets nationally since 2022, according to Ministry of Health records.
The resulting surge in infections is overwhelming local healthcare infrastructure and threatening the survival of Malawi’s most vulnerable populations.
In 2025 alone, Dedza District Hospital recorded over 217,000 malaria cases. Children under five accounted for nearly a third of those infections and 32 of the district’s 60 recorded deaths from the disease.
Hospital statistics show that between January and April 2026, the district has recorded 10 deaths in children under five and 18 deaths in those over five during this period, while another 534 pregnant women were diagnosed and treated.
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Furthermore, health workers treated 8,325 confirmed malaria cases in children under five and 22,121 cases in people over five.
Despite these grim statistics, the practice of diverting medical resources remains rampant.
Pampara [not real name], a 32-year-old farmer who uses a free insecticide-treated mosquito net in her vegetable garden, was among 500,045 beneficiaries of a recent government door-to-door distribution campaign in the district.
Instead of hanging the net over her bed, she took it straight to her garden.
“I got the mosquito net from health personnel who were going door to door. I decided to use it as a shield for my vegetable garden against chickens and other predators since I had no intention to use it,” she admitted.
She is far from being alone. A short drive away, in Senior Chief Chilikumwendo’s area, Matigadi [not real name] uses his government-issued nets to spread and dry groundnuts, claiming they keep birds from eating his harvest.
“But for some of us, it is difficult to use mosquito nets at night. Some of us do not like sleeping in mosquito nets,” Matigadi says.
While the two individuals view the nets as free household utilities, families lacking protection pay the ultimate price.
Five-year-old Fatsani Matenje, from Kapesi Village under Senior Chief Kachere, is one of the fallout’s latest casualties.
When Fatsani was admitted to the district hospital with malaria, her mother, Merifa Matenje, watched over her daughter’s bed with a mixture of grief and anger. She explained that their household was completely skipped during last year’s distribution exercise.
“My family was not part of those that received the free mosquito nets. It is deeply painful that those who received the nets have chosen to abuse them. It feels like they are killing those of us who never had the chance to get one. Now, my child is the victim,” Merifa says
The crisis extends heavily into the facility’s maternity wing.
Zainab Alli, an expectant mother, lies in agony on her hospital bed, battling infection. Although national medical guidelines dictate that pregnant women must sleep under insecticide-treated nets to protect both mother and the unborn child, Alli did not have one.
“Unfortunately, my household was missed out during the distribution of the nets and buying one on the market costs more than K20,000, which I cannot afford,” she says
Dedza District Hospital Malaria Programme Coordinator James Chikankheni warns that the misuse of nets has deadly consequences.
“When pregnant women and under-five children do not sleep under treated nets, malaria cases spike. In pregnancy, malaria increases the risk of abortion, miscarriage, stillbirth, low birthweight and neonatal death.
“It also causes severe anaemia in both mothers and young children. In men, severe malaria can lead to kidney failure. So, communities have to prioritise net use to protect themselves from malaria,” Chikankheni says.
He, however, says the district is fighting back with multiple interventions, but behaviour is undermining progress.
“In 2025, we prepared 10,214 insecticide-treated nets for pregnant women and 7,946 nets for newborn babies during antenatal and postnatal care. We also administered 50,242 doses of Sulfadoxine- Pyrimethamine for Intermittent Preventive Treatment in pregnancy at antenatal clinics,” Chikankheni says
This local crisis mirrors a darkening global picture. According to the World Health Organisation’s World Malaria Report for 2025, global malaria cases have climbed to 249 million, resulting in 608,000 annual deaths, a resurgence driven by biological threats such as drug and insecticide resistance alongside massive funding gaps.
In Dedza, these challenges are severely exacerbated by the misuse of tools such as insecticide-treated nets and critical gaps in supply chains.
Malawi Health Equity Network (MHEN) Executive Director George Jobe calls for an urgent solution to end this malpractice.
“It is very unfortunate when some citizens misuse mosquito nets they receive freely from the government. Such nets are counted as part of Malawi’s efforts to combat malaria by 2030. We recommend that guidelines and by-laws be set, with legal tools to ensure that if there is abuse of free mosquito nets, the person faces the law. “There is also a need for monitoring of the nets by health surveillance assistants (HSAs), chiefs and community leaders to ensure people are using them correctly,” Jobe says
Senior Chief Kamenyagwaza welcomes the suggestion.
“Behavioral change is needed, especially for people in rural areas, because that is where the situation has worsened.
“We, as chiefs, have to come up with by-laws and should be monitoring how our people are utilising the mosquito nets,” Kamenyagwaza says.
Speaking at commemorations marking World Malaria Day in Lilongwe in May 2026, Health and Sanitation Minister Madalitso Baloyi explained that the government continues to scale up key interventions to eliminate the disease by 2030, including the nationwide distribution of over 11.7 million mosquito nets.
According to the Malawi National Malaria Strategic Plan, achieving this goal will require K1.1 trillion. This funding is critical to meeting Malawi’s commitments under Sustainable Development Goal 3 (Good Health and Well-being) and Human Capital Development pillar.
The Malawi 2063 vision emphasises that a robust economy relies entirely on a healthy workforce.
However, Dedza’s scenes of nets shielding vegetables instead of children and pregnant women threaten the very survival of the nation’s most vulnerable citizens.
