Making Lifesaving Treatments Available to Children in Rural Mali

Samata village, Mali, is a rural, agricultural community of about 1,200 people located 35 km (more than 21 miles) from the nearest community-owned health center of Djidian, and 75 km (about 46 miles) from the nearest Reference Health Center of Kita. Before the Community Essential Care program was implemented by the JSI-implemented Maternal Child Health Integrated Program (MCHIP) in collaboration with UNICEF and other partners, the villagers in Samata would walk for four hours to seek care in Djidian when their children were sick. Lack of accessible and high-quality health services took the lives of many children, with malaria being the leading cause of mortality.

Toumani Dagno, a community health worker trained by MCHIP,
teaches people in his community about the importance of
preventive health measures, such as building latrines and
regularly washing one's hands. Dagno also effectively tests for
and treats malaria--a common killer of children in rural Mali.
Toumani Dagno, who is from another village within the Kita district, took interest in the community health worker position (Agent de Santé Communautaire [ASC]) in Samata. He successfully passed the required exam and was appointed as the ASC by the villagers in September 2011. MCHIP provided Toumani with training to address the community’s needs and he was officially installed in Samata to provide treatment to children suffering from diarrhea, malaria and pneumonia.

Motivated by the number of preventable child deaths in Samata, Toumani understood well the need for high-quality services at the community level and the importance of involving local leaders and actors in mobilizing the community. After completing his training, he did not wait long to begin this process, informing villagers about his assignment, requesting help from the community women and youth groups, and initiating discussions to engage and involve the village authorities. As a result, the village happily welcomed Toumani and his presence and work were met with relief after much suffering.

Since Toumani’s work in Samata began, the villagers have come to better understand how important it is to take care of their own health. This community commitment to health now includes a weekly “day of safety” organized by the women and youth groups with Toumani’s help. All households in Samata were also encouraged to build latrines and, as kits for proper handwashing became more available, most families began to regularly wash their hands with soap after using the latrines and before preparing or eating food.

Most importantly, with MCHIP’s help, children in the village now have access to lifesaving treatment. When Toumani’s work began, he treated an average of 10 sick children every month. However, his kindness, dedication, and the quality of his services quickly made him popular. Now, even parents from neighboring villages approach him to seek care for their sick children. Toumani uses a rapid test to confirm if a fever is caused by malaria before treating a sick child, and a timer to determine if a coughing child needs antibiotics. One year after his work began, the number of clients he sees has increased more than 10 times: from October 2012 to March 2013, he treated a total of 616 sick children in six months; among them, 437 tested positive for malaria and were immediately given anti-malarials; another 10 were severely ill and referred to the nearby health center of Djidian.

M Sidibé Bourama, the 50-year-old advisor to the village chief, described Toumani’s work:
"We are very satisfied with the work of the ASC in our village. The number of deaths has decreased in our village. In comparison, last year at the same time we have had 10 deaths of children less than five years old, including two of mine. Today, we can thank God; because of the presence of Toumani, we have not yet registered any child deaths. Also, due to his perseverance, we bought our handwashing material and we wash our hands. He became the friend of women to organize a weekly day of safety in the village. There is less travel to the health center to treat children and this has reduced the burden on families for the transport and care.”

Samata is one of 100 MCHIP-supported villages in Kita and Djema districts where many children do not have easy access to regular health facilities. And Toumani Dagno is one of the 100 ASCs who have been trained, equipped and supported by MCHIP in collaboration with UNICEF to provide lifesaving care and treatment to sick children in these hard to reach villages.

M Sidibé concluded: "Putting the rooster in the cage is the responsibility of the owner; putting the tail in the cage is the responsibility of the rooster itself." In other words, MCHIP has made available to the people of Samata village an ASC to provide care; now it is the villagers' duty to organize themselves to use these services.

The Maternal and Child Health Integrated program (MCHIP) is USAID's flagship maternal, neonatal and child health program, which focuses on reducing maternal, neonatal and child mortality. MCHIP is designed to accelerate progress toward achieving the Millennium Development Goals (MDGs) in USAID's 30 maternal and child health priority countries over five years.
JSI leads MCHIP's work in the areas of child health, immunization and pediatric HIV/AIDS. MCHIP is the follow-on project to BASICS and IMMUNIZATIONbasics, other USAID global technical assistance projects which were also implemented by JSI.