Malaria is one of the leading killers of young children in Africa. Ghana was among the first three countries to offer a malaria vaccine through routine child immunisation, starting in selected districts in 2019, and a four-year evaluation now shows what that meant for child survival.
The evaluation covered 158 areas in Ghana, Kenya and Malawi, including 66 districts in Ghana. Half were randomly chosen to start giving the RTS,S vaccine in 2019 and the rest waited. Ghana's comparison districts began vaccinating in February 2023.
Across the three countries, deaths from all causes except injury among children old enough to have had three doses were 13% lower where the vaccine was introduced, or about one in eight deaths averted. Admissions for severe malaria in monitored hospitals were 22% lower. The researchers estimate 993 child deaths were averted over 46 months and found no evidence that the effect differed by country.
In Ghana's vaccinating districts, 479,200 children received the first dose, 431,836 the third and 198,092 the fourth, and coverage of the later doses was higher than in Kenya and Malawi. The vaccine also reached children with less protection: 37.4% of Ghanaian children aged 12 to 23 months in the final survey did not sleep under a treated net, yet 73.3% of them had three doses.
The gains came even though only about 40% of children across the three countries received the fourth dose. Ghana moved that dose from 24 to 18 months in February 2023, alongside the second measles jab, and uptake improved. Coverage tended to be lower in poorer households, so reaching more children with every dose could save more lives.
Research Scope
This article is based on a peer-reviewed journal article published in The Lancet in May 2026 and held in the University of Ghana's UGSpace repository. Its authors include researchers from Ghana Health Service research centres, the University of Ghana and KNUST. It is a cluster-randomised evaluation of 158 areas in Ghana, Kenya and Malawi, including 66 districts in Ghana that were chosen because they had year-round malaria transmission. The 13% fall in deaths is a combined estimate for all three countries, not a separate figure for Ghana, and coverage figures come from household survey samples. It is a research signal from selected high-malaria districts, not a full national survey.