Mali Health Organizing Project

Mali Health empowers Sikoro, an impoverished urban community in Mali, West Africa to transform maternal and child health sustainably. We do so by: -Fostering the agency of residents and community structures to mobilize to address community health needs. -Promoting health education, prevention, and early care seeking. -Enhancing financial, geographic, and cultural access to health care for poor families.
Mar 17, 2014

"With the Health Fund, There is Hope"

A Health Savings meeting
A Health Savings meeting

One of the primary reasons Malian families don’t seek care at the clinic is the high cost of treatment.  Though we work with the clinic and other partners on initiatives to bring down the cost of a visit, the price remains out of reach for many families.  Thus, through Action for Health, we provide free care to nearly 2,000 children under age 5 and subsidized care to over 900 pregnant women.  Through the program, these children and mothers receive the care they need when they need it without the worry of financial burden.  However, it is also our aim to create models in which families can better support themselves. We want to foster independence so that all families can access the care that they need with or without our assistance.  So, in 2013, we launched the innovative Health Savings program.  

Through the program, groups of women from across the community come together weekly to learn about preventive health care and financial management.  These women also deposit small amounts of money into two collective accounts.  In the first, members draw loans to support revenue-generating activities, such as starting a small business.  From the second, women access no-interest loans in order to cover health costs at the local clinic.  At the end of a cycle, women are returned their savings, along with the dividend through interest earned, and encouraged to make good on initial commitments to allocate funding saved to preventive health products. By removing the burden of cost from a single family, these women can now ensure that they and their children seek treatment as soon as they need it and can afford to follow the treatment as long as necessary. 

Assan O. is a recent beneficiary of one of these health loans.  When she fell sick, she was unable to carry on her business, and stopped earning an income.  At first, she was afraid to take out a loan from her Health Savings group because she feared she wouldn’t be able to pay it back in time.  She sought treatment at the clinic with the little disposable money she had, but it didn’t cover the medicines the doctor prescribed.  Assan couldn’t afford the medication, and so she went without it for days, her condition worsening. 

When the Health Savings coordinator visited Assan, he could see that her health was not improving.  When she told him why she didn’t take a loan from the group, he assured her that she need not worry – they would find a way to help her repay her loan. She borrowed enough funds to purchase her medication.  Her health improved very quickly after that, and at the next Health Savings group meeting, she explained the situation to her fellow members.  They understood her predicament and granted her 60 days to repay her loan, rather than the usual 30, enough time for Assan to return to her business and earn an income once again.  After 47 days, she repaid her loan in full. 

Asked afterward how she felt about the Health Savings program, Assan said, “This is very important to the women of this community.  With initiatives like this, we will not be afraid to reach out for care for a lack of money because with the health fund, there is hope.” 

Dozens of women have benefitted from the loans they withdrew from their savings groups since the program began.  Some, like Assan, have paid for health costs.  Others have used their loans from the general fund to start or expand their businesses.  Aicha S. from Bandiagara Coura used her loan to build on her already-successful small business selling earrings.  She put the funding toward expanding her collection to include beads, necklaces, bracelets, and makeup kits.  With the extra money she has earned from her new products, she paid back her loan within a month and now is earning more than ever.

Health Savings drew its first cycle to a close earlier this year, and group members and non-members alike made it clear they wanted a second cycle to begin immediately.  Over 130 women participated in the first round. Between them, they withdrew nearly 75 loans, 17 of which directly subsidized health care costs.  Over the course of the first cycle, group members learned not only about managing their money, but also about the importance of seeking early treatment for their illnesses, how to recognize danger signs in children, and what a woman can do to ensure she has a healthy pregnancy.  

With International Women’s Day this month (it was March 8th this year), we are reminded of how much power women possess to be change agents in their communities.  The health and education of women has a direct and irrefutable impact on the wellbeing of their children, and thus on the future of the entire community.  Through Action for Health, we are ensuring that mothers receive the care and education they need so that they can keep their families healthy.  And through Health Savings, we will help those same women to build the independence they need not only to support their families, but to have the power and resources to shape and change their communities for the better.  

Members reconciling their group accounts
Members reconciling their group accounts
Aicha used a small loan to purchase goods to sell
Aicha used a small loan to purchase goods to sell

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Dec 12, 2013

Kassim

A celebration of health
A celebration of health

Mariam Fofana Diallow is the Programs Director at Mali Health Organizing Project (not Mariam Samessekou, the Community Health Worker profiled in our last report). While she loves her job, it isn’t always easy to face the daunting challenges present in the field of maternal and child health in a developing country. On a day in late August this year, she was reminded of the true importance and meaning of her work.

Mariam was working in her office when a woman stepped into the terrace, looking for someone to talk to. Mariam could see that this woman was brimming with excitement, and invited her inside. The woman, who introduced herself as Djelika Sogore, carried a healthy, smiling baby on her back. As she greeted Mariam, she handed the baby to her, proudly showing off her grandson.

The woman started to talk about the baby, Kassim, an 18-month old boy, her pride visible and contagious. Djelika’s daughter died giving birth to Kassim after a cesarean section, leaving Djelika to care for him in her stead. Djelika, while heartbroken, embraced Kassim as the last remaining link to her daughter and a much-needed inspiration in an otherwise tragic time. Unfortunately, shortly after her daughter’s death, Djelika’s tragedy seemed as if it would soon double as Kassim grew very ill and thin. Djelika said, “I thought that misfortune was still knocking on my door and that I would lose what was left of my daughter.”

Djelika’s luck changed when officials from Mali Health arrived. Kassim was suffering from malnutrition and a severe respiratory disease. He was taken to a hospital where he received intensive care for a month. With the help of Mali Health, Kassim fought for his life and won. When Djelika was able to take Kassim in her arms once again, she was overwhelmed with happiness, telling Mariam, “he looked at me with eyes that remind me of my daughter; that look flooded my heart with joy.” Djelika sought Mariam out in order to share the jubilation she was so thankful for with those who made it possible.

Even though Mali Health faces significant challenges, stories like that of Djelika and Kassim keep Mariam motivated. Looking at the small child, she thought of her own son and late daughter, and began to cry. Kassim’s second chance at life serves as a testament to the power of the fulfillment of Mali Health’s mission. No child’s life should be put in jeopardy by a preventable or curable illness. What motivates Mariam is what motivates Mali Health: “Saving lives, providing dignity and empowerment, and giving hope to people forgotten by the health system.”

Over the last months, Action for Health has achieved impressive numbers. Health Workers conducted nearly 8,000 home visits. 1,217 children completed clinic consultations, made possible by Mali Health’s financial support. At a recent meeting, mothers stood and recounted the progress of their children and their communities with Mali Health’s intervention, met by much applause. As Mariam currently spends two weeks making visits in the US, she is relaying the messages of hope and gratitude from the many like Djelika and Kassim, partners in our progress.

Enrolled mother Fanta speaks about the program
Enrolled mother Fanta speaks about the program

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Sep 12, 2013

Meet Mariam

Mariam
Mariam's routine visit caught an early illness

Over the past year, Mali Health has expanded Action for Health to nearly 2,000 children under 5 years old, made possible by a frontline team of local health workers that serve as a vital link between the community and the health system. Mariam Samassekou is one of those health workers, and this month, celebrates one year on the frontlines with Mali Health.

Every day over this past year, Mariam has faced the challenges and rewards that come with working directly with families to improve the health of her community. She regularly visits over 100 children in the poor and isolated community of Sikoro-Sourakabougou, on the outskirts of Bamako. She monitors the health of children – taking their temperature, height and weight, and checking for signs of malnutrition. She consults with the parents about the measures necessary to ensure proper nutrition, sanitation, and health for their children during their most formative – and vulnerable – years. And when a child is sick, she informs the parents of the need to go to the local community health clinic, and accompanies the child to make sure he or she gets fast and appropriate care.

Over the last month, Mariam conducted 150 home visits to families in Sikoro. Among them, she conducted 6 prenatal evaluations, and accompanied 17 children to the clinic. One of these children was Baba.

Last month, during her routine visits, Mariam noticed Baba showing signs of malnutrition, a common yet dangerous problem among young children in Mali. Poor families here often rely on simple meals high in inexpensive carbohydrates and low in protein and other nutrients. If unrecognized or untreated, malnutrition like Baba’s can lead to developmental delays and make other common childhood illnesses in Mali – such as malaria or measles – more dangerous and costly to treat. It can also kill. Luckily for Baba, this wouldn’t be his case. As soon as Mariam spotted the symptoms of malnutrition during her regular visits, she was able to bring Baba to the clinic, where he was seen by a doctor and received immediate treatment. The entire time, Mariam was on-hand to make sure Baba was seen promptly, received appropriate care, and that Baba’s parents understood his condition, what caused it, how to treat it, and how to best prevent it in the future (among them, more high nutrient meals, the theme of recent health worker culinary demonstrations).

Mariam is one of 19 health workers. And Baba is one child of the 1,886 now enrolled. Eight months into this year, Mali Health’s cadre of community health workers have conducted 17,426 home visits, accompanied nearly 900 sick children to the local clinic, and provided prenatal care for 126 pregnant mothers. Local morbidity and mortality rates have dropped, and through a innovative new financing approach, we’ve also seen the average price of these visits (covered by Mali Health) fall from $11.89 to $8.19, a 31% reduction. Currently, we are in the process of evaluating year-1 results of the collective impact of this work, but to Mariam and her fellow health workers, it’s all about one child like Baba, one lifesaving visit, and one family educated and empowered at a time.

Receiving care at the clinic
Receiving care at the clinic

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