In Mali, the mortality rate for children under five is about 20%, higher than the overall child mortality rate in the World Health Organization Africa Region. It performs worse than much of the region in per capita GDP, government expenditure on health care, maternal mortality rate, and many other measures.
Here at the College this week, representatives from Mali Health Organizing Project paid a visit to tell us about their work. Mali Health is a nonprofit group working to reduce child mortality and improve maternal and child health in under-resourced communities in Mali’s capital, Bamako. Since 2006, it has trained and deployed community health workers to work in Bamako’s slums, where they make home visits to evaluate child health, and help facilitate access to healthcare for children and pregnant women. Seeing a need to more directly provide health services, the group built a community clinic in 2010 and a maternity ward in 2013 to widen its reach in the poorest neighborhoods of the capital area.
Mali Health’s focus is on low-cost interventions that will directly help the poorest people in Bamako and will also help to strengthen health infrastructure and the community. Mali Health Executive Director Kris Ansin said, “Low-cost interventions at the community level have the potential to improve health outcomes, save lives, and create sweeping changes in the landscape of possibility on child survival.“
Community health workers monitor children’s immunizations to make sure they are up to date with Mali’s immunization schedule, which officially includes BCG, DTP, Hib, hepatitis B, measles, oral polio, pneumococcal conjugate, and yellow fever vaccines. (Unfortunately, rotavirus vaccine is not yet given in the country, and diarrheal disease is a leading cause of death for children under 5). They provide other vital services to monitor and improve child health, including escorting sick children to clinics where they can get needed medical care. They also work on supporting positive health behavior changes in the family setting.
Joseph Camardo, MD, who is a History of Vaccines advisor, Celgene senior vice president, and president of the US Board of Directors of Mali Health, emphasizes the importance of community-driven efforts to improve health in Bamako: “In the Mali health system the local communities are responsible for developing and supporting health care specific for the needs of the community. Our community health worker program in a poor neighborhood of Bamako works to make sure that one important need, for maternal and child health, is met with education to recognize symptoms, preventive care, and access to a local clinic with trained professionals.”
A group at Brown University is conducting a randomized control trial of Mali Health programs to assess the impact they are having on child mortality and health behaviors. An evaluation of a similar project near Bamako was recently published in PLOS ONE: it showed that after deployment of community health workers, child mortality improved as did several measures of health and health care access.
We’re looking forward to the results of the evaluation of Mali Health’s programs, and we wish them the best for great success in 2014. To learn more about Mali Health, visit their website to read about their programs.