Hello from Bamako. My name is Leona Rosenblum, dite Maimouna Diallo, and I am the Coordinator of the Action for Health Program. As Alex mentioned in her last update, Action for Health has been fully operational since March 1st. And a very exciting four months it has been! Action for Health is a complicated program that involves a lot of different pieces, and we’ve been working on getting all those different aspects up and running. Here is an explanation of all the components that make this program what it is:
1) Health in the Home
AFH works within the home to improve child health outcomes. We do this with the help of eleven wonderful Community Health Workers (CHWs) who visit the families twice monthly do to peer monthly thematic health education sessions as well as basic health indicator check-ups. The peer education sessions focus on disease prevention, essential understanding of transmission, and key knowledge for in home disease management (protein sources for malnourishment, rehydration for diarrhea, etc.). The checkups focus on indicators of the diseases responsible for 90% of child mortality in Mali: malaria, acute respiratory infection, diarrhea and nutritional status (Malian Ministry of Health.
The CHWs are a key resource in the fight against child mortality, not only through their work towards disease prevention but in making sure sick kids get to the clinic FAST. Families are encouraged to contact their CHW in the case of any signs of illness, at which point the CHW either comes to the home to check in on the child right away, or refers them straight to the CSCOM. After the patient is seen by the doctor, it is the CHWs who follow-up at home to make sure that caregivers received all the medications that were prescribed and that they know how to use them. With 383 patients enrolled in the program, the CHWs have been busy. In the last four months, they’ve already done more than 3000 patient visits total!
2) Free Primary Health Care
Every child referred to the clinic by the CHW receives a free consultation and, if the diagnosis relates their symptoms to key causes of child mortality, free treatment. This is the piece of the Action for Health puzzle that has had the most immediate impact within the community. We’ve already treated 200 patients at the local Centre de Santé Communautaire de Mekin-Sikoro, and we’re starting now to treat patients at the Centre de Santé Communautaire de Sikoro-Sourakabougou. That’s the center that MHOP was able to build with generous support from you. 200 patient visits in only four months means that we are on target to reach our goal of at least 2 clinic visits per child per year.
3) Increasing Investment in Health
At the Mali Health Organizing Project, we believe that free care is not the end goal. Instead we work to encourage community investment in health care to facilitate community empowerment and ownership over their own health challenges. Families enrolled in AFH invest in their health care through community service action-fees, such as voting on local health clinic boards and community clean up days. Action Fees are designed by the Community Health Action Group to best harness the capacity of the target families to mobilize the community and improve health in Sikoroni. A representative of each family is required to participate in 6 Action Fees per year, and we held our first one last month. Though we had some trouble due to rain and some miscommunications, we got the designated area cleaned up in record time. In the near future, we will be focusing on Nutritional Education Sessions for women with children suffering from malnutrition. After they are trained to make enriched porridge and other highly nutritious meals, they will go on to host trainings for other people in the community. The CHWs are working with the families now to brainstorm more ideas for great actions going forward.
So there you have it, the basic foundation for Action for Health. On top of that, we’ve added a partnership to pilot Frontline SMS: Medic’s new program Patient View. As of last week, the CHWs are now sending in the records of their patient visits via SMS! It is incredibly exciting to watch the flow of information happen in real time. The visit file is sent directly to the clinic, where it is attached to the patient’s file within the program’s computer based medical records system.
Everyone is excited to have this incredibly useful piece of technology finally in place. When children are sick, the information arrives at the clinic before they do, alerting the doctor. When they arrive, the clinician has access to all their prior medical history, and a place to record their consultation notes to add them to their file. Follow up on medical treatment is a huge issue here and Mali, and we’re hoping to see real improvement now that we are using Frontline SMS: Medic. As soon as the doctor finishes his diagnosis and prescription, he or she can send a message straight from their computer to the CHW to tell them what day the patient ought to finish their treatment, and whether they should come back for a follow-up visit.
The rainy season is just starting here in Mali, and this is a time when everyone, but especially children ages 0-5, are the most at risk of catching malaria. We have our work cut out for us in the coming months, but as you can see we are off to a great start. As always though, we can’t do any of this without your continued support. Thank you again for all that you have made possible.
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