Geospatial mapping of gender-sensitive malaria vulnerability and ITN usage barriers in Zamfara State, Nigeria

BACKGROUND: Malaria continues to pose a serious public health challenge in Zamfara State, Nigeria, disproportionately affecting women and children due to socio-economic barriers. This study aimed to develop a Composite Gender-Sensitive Malaria Vulnerability Index (CGMVI) to identify areas of heightened malaria vulnerability and support informed targeted interventions. METHODS: Malaria incidence and mortality data from the Malaria Atlas Project, and population data from WorldPop, were integrated with indicators of Insecticide-Treated Net (ITN) access and usage, maternal education, and household wealth. A Pentagonal Fuzzy Analytic Hierarchy Process was used to compute the CGMVI, while Getis-Ord Gi* hotspot analysis identified spatial patterns of vulnerability across Zamfara State. RESULTS: The CGMVI revealed a west-to-east gradient of malaria vulnerability across Zamfara State, with hotspots in Gummi (3.86) and Bukkuyum (3.62), characterized by low ITN usage (82-85%), high maternal education deficits (89-91%), and household poverty (85-90%). Moderate vulnerability was observed in central Local Government Areas (LGAs) such as Anka and Bungudu, while northern and eastern LGAs, including Shinkafi, Zurmi, and Tsafe, exhibited low vulnerability with higher ITN coverage (≈92%) and better socio-economic profiles. Hotspot analysis using Getis-Ord Gi* confirmed statistically significant clustering in western LGAs (z-scores 2.11-4.89 at 99% confidence), while coldspots in the north and east had z-scores from - 1.69 to - 3.39. These patterns reflect intersections of socio-economic barriers, ITN access, and maternal education, highlighting areas where women and children face elevated malaria risk. CONCLUSION: The study offers a spatial framework for understanding how epidemiological, socio-economic, and gender-related factors shape malaria vulnerability in Zamfara State. By identifying areas where women and children may face elevated risk, the findings can inform gender-sensitive ITN distribution, community malaria literacy initiatives, and socio-economic support strategies. The CGMVI provides a tool to guide evidence-informed planning and better integrate gender considerations into malaria control efforts in the state.