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 Health  Mali Project #3185

Action For Health : Empowering Communities in Mali

by Mali Health Organizing Project
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali
Action For Health : Empowering Communities in Mali

On Wednesday 10 July, Mali Health was honored by the Sotuba community in recognition of our partnership, and the impact it has had on improving community health. While we were the ones being recognized, for us, this event was actually a chance to celebrate the strong leadership in Sotuba, and the community's investment and ownership of their health, and health system.

Sotuba is a peri-urban community on the eastern side of Bamako. Mali Health collaborates with the health center (CSCom) to improve healthcare quality and governance, as well as supporting community health workers and women’s health savings groups there.

The celebration featured staff from Mali Health, members of the community, and the president of Sotuba’s ASACO (Association de Santé Communautaire), the organization made of community members that oversees the health center. The ASACO serves as a bridge between the health center and the surrounding community, linking the organization and the people. 

The ASACO has a key role in helping to improve the health of the community. When a community has an organized and efficient ASACO, the CSCom’s work is tailored to the specific needs of the people it serves, the CSCom becomes more responsive, and the amount of women and children seeking care at the health center increases.

Sotuba is one of the smallest communities with whom Mali Health collaborates. When the partnership began, the ASACO had no structure or organization and it was unclear to the community and the health center what exactly the role of the ASACO was. Unfortunately, most low-resource communities in Mali face the same challenge and one of the most important pillars of the community health system often is not able to fulfill its role of ensuring strong management, accountability and community participation in health centers.

Today, Sotuba's ASACO is an active group of community members who are fulfilling that essential role - and they are seeing impressive results. On a measurement scale we use for transparency and accountability, Sotuba went from being one of the lowest-scoring partners to one of the highest. Sotuba's patient satisfaction scores are consistently among the highest, over 95%, and the rates of pregnant women returning to deliver at the CSCom are the highest of any of our partners - sometimes reaching 100%.

As one of Mali Health’s first partners to implement, test, and refine our participatory quality improvement (QI) approach, their hard work speaks for itself. For several years, a QI coach has provided technical support and coaching to a QI team at the Sotuba CSCom and we are now in the process of turning the QI program over to that team, so that they can continue serving their community at this high level.

To support the efforts of the health center and extend the impact of improvements in quality, Mali Health has provided community health workers and free or subsidized healthcare to children and pregnant women with the least access. We also help women in Sotuba access more financial resources that can help them improve their family’s health. By addressing preventive healthcare, hygiene, and budgeting, these strategies aim to advance health in Sotuba by helping women gain more knowledge about their children’s health and increase their ability to act on it.

A mother and savings group member who attended the celebration shared her experience:

“Two times a month, Mali Health makes contact with us parents, to see the evolution of the state of health of the children. They are really there for us; we are really grateful. They educate us about the nutrition of our children and hygiene. The savings funds that Mali Health helped us set up helps us a lot to provide hygiene products such as our soaps and other cleaners. I'm so grateful that I have tears in my eyes about Mali Health.” 

Mali Health’s overarching goal is to support the Sotuba community to improve access to healthcare; the partnership is rooted in the community’s desire for change. Although there is more work to be done, this celebration represented an important milestone and the core of what makes Mali Health’s approach different. While Mali Health can give support to the health center, mothers and community members to improve health and to make change, it is up to them to decide whether to adopt strategies, act on information, and to take ownership of those strategies to sustain that change in the long term.

As the president of the ASACO described it, to the community, Mali Health represents the idea that a different future is possible, and within their reach. During his acknowledgement, the president reflected:

“I remember a story that was told to me by one of my teachers: a little boy from a small village became a doctor and became a source of hope for his entire community. This little boy reminds me of Mali Health which has become the source of hope for our community.”

Members of the Sotuba community have seen the change they are able to make to improve the health of mothers and children. While Mali Health remains so grateful for their partnership, and their gracious efforts to recognize what our partnership has achieved, we are most excited by the real steps forward that community members in Sotuba are taking to actively participate and take ownership of their health system and its future.

Every community with whom we work will always have our support, but our role is to strengthen their ability to manage and improve health in their communities, so that they can take the lead.

When they are the ones who start giving us the certificates and the chiwaras - then we know we’re all doing something right.

Links:

Mali Health Community Health Workers
Mali Health Community Health Workers

You probably know that your support of Mali Health community health workers goes a long way, but it also has an incredible impact.

In January, our team of community health workers celebrated an amazing milestone:

For 5 years, they have not lost a single mother or child in their care.

To put that in perspective, elsewhere in Mali, 1 in 9 children still do not reach age 5. One in 26 mothers die from causes related to childbirth. These numbers are devastating - and are difficult odds to overcome.

But with your support, our community health workers have. They have served thousands of mothers and children in the past five years - and they have saved lives.

They could not have done it without your support, and we are so grateful.

We'll be celebrating this amazing accomplishment all year long, but we started with a celebration of all our community health workers in February. They work so hard for families in their communities - and they deserved a party!

Thank you so much for your support of them, and the families they serve.

Thank you for believing that all mothers and children deserve access to healthcare.

The Mali Health CHW Team
The Mali Health CHW Team

Links:

CHWs carry essential supplies in their backpack
CHWs carry essential supplies in their backpack

We often talk about training and equipping our wonderful community health workers, but have you ever wondered exactly what equipment they need to do their work?

Every Mali Health community health worker carries a backpack, which contains some important equipment that helps them monitor the health of the children in their care. Here's what they use:

  • Scale - to measure children's weight and track their growth
  • Brachial or MUAC (mid-upper arm circumference) tape - to measure arm circumference, which more accurately screen for acute malnutrition
  • Digital thermometer - to measure body temperature and catch early signs of a fever
  • Smartphone - our community health workers record all the anthropometric measurements into the mHealth app we use to monitor and track children's health information

Not only is this equipment essential for doing their job - it helps our community health workers take pride in what they do. In addition to their backpack, you'll also notice that our health workers often wear a Mali Health vest - their uniform. Both the backpack and the vest makes them more visible in their communities and helps community members and health workers recognize the professionalism, and importance, of their work.

All of your contributions through GlobalGiving goes to train, equip and support Mali Health's community health workers. They are pivotal to improving maternal and child health in the peri-urban communities we serve. Despite very high maternal and child mortality rates in Mali, Mali Health community health workers have not lost a single mother or child in their care in five years.

Gauanse packs her backpack
Gauanse packs her backpack
Weighing a child
Weighing a child
Measuring and recording arm circumference
Measuring and recording arm circumference
Taking a temperature
Taking a temperature

In our last project update, we followed one of Mali Health's community health workers, Gauanse, on her daily visits to families in her care.

We'd like to show you a bit more of where Gauanse and our other community health workers diligently visit mothers and children everyday - in Bamako's peri-urban communities. For the most part, peri-urban communities are informally settled and lack access to basic services.

Navigating some of these communities can be challenging - but Gauanse and her colleagues make it look easy. Community conditions not only makes the work of community health workers more important, but make us appreciate them, and their hard work and dedication, even more.

It is your support that makes their work to serve mothers and children in Bamako's peri-urban communities possible. Thank you so much!

Take look below to see where Gauanse's work takes her everyday:

Links:

Like many parents around the world, Gauansé’s day starts early - at 5am, to be exact. She makes breakfast and lunch for her 8 year old daughter and 3 year old son, then packs her bag, walks the kids to school, and begins her day as one of Mali Health’s 35 community health workers.

Gauansé works in Sikoro, the community where Mali Health was founded nearly twelve years ago. Plenty has changed in Sikoro over those years, but in these steep, rocky hills, traveling by foot is still the safest and most efficient way to reach the families in Gauansé’s care.

Gauansé meanders up the path to visit the first family of the day. Hawa (4 years old), Wassi (3 years old), and Diatou (4 months old) live here with their mothers, Ya and Alimatou. Gauansé has been visiting the household roughly every two weeks since Hawa joined Mali Health’s program three years ago.

Community health workers like Gauansé serve families in a number of ways. Gauansé starts her visit by checking Wassi’s temperature to make sure she doesn’t have a fever — a common sign of malaria, which can be very dangerous in young children.

Gauansé also measures the children’s weight and arm circumference to monitor for malnutrition and asks their mothers about any recent symptoms of illness.

As she collects the information about the children’s health, Gauansé records everything in a mobile phone app, which will analyze the information and prompt Gauansé if the children are showing any warning signs of illness.

If any of the children are sick, Gauansé will encourage their mothers to bring them to the health center right away, where they will receive proper treatment and can start recovering quickly. Mali Health covers the cost of this care for children enrolled in the program so that families will not delay seeking care for fear of not being able to afford it.

After working with the children, Gauansé turns her attention to Ya and Alimatou. In addition to monitoring children’s and pregnant women’s health, Gauansé provides families with health education, discussing topics that frequently impact their health — such as nutrition, family planning, breastfeeding, and malaria — and giving them the knowledge they need to prevent disease and keep themselves healthy. Today, Gauansé focuses on hand washing in light of the upcoming cold/flu season; she doesn’t lecture, but rather engages Ya and Alimatou in a dialogue to learn about the topic together.

In three years, Gauansé has been through a lot with this family, and she’s seen the children grow. Last year, when she learned Wassi was sick with malaria, she accompanied Wassi and Ya to the Sikoro health center, stayed by their side through the consultation, and made sure Ya got the right medication before they left. Health workers like Gauansé are not just providers for the families in their care — they’re friends, too.

With plenty of well wishes, Gauansé leaves Ya, Alimatou, and their children to walk to the next family’s home. Along the way, she reflects on how she got here: she was a nursing student at one of the local health centers when Mali Health began its work. Soon, she noticed a lot of children arriving at the center, referred by the Mali Health team.

“I asked the doctor about the program,” she says. “I thought Mali Health was doing important work, and I wanted to be part of it. That’s how I became a community health worker.” Gauansé has been a proud member of our team for five years now, and we’re lucky to have her.

Gauansé is arriving at another family's house, where she’ll check in on Sounkara and Drissa, both two years old. She’s been visiting them twice a month since just after they were born. They’re too young to be in school just yet, but they learn plenty from Gauansé!

During her visits, Gauansé usually sits in the courtyard surrounded by the women and children of the household (and occasionally some interested neighbors!). Many of the families in Mali Health’s partner communities live in houses like this one with concrete walls, a tin roof, and an open space where families can gather and children love to play. Both Sounkara’s mother, Mom, and Drissa’s mother, Sata, work informal jobs to earn extra income. Sata cooks all day and sells the food along the roadside in the evening to hungry passersby. Mom sews maternity blankets for new mothers in the area and sells them to local families.

Once again, Gauansé starts her visit by taking the children’s temperatures and weight. Drissa is a bit too young to stand on the scale himself, so here, his mother Sata steps in. She’ll weigh herself first, then weigh herself while holding Drissa and calculate the difference.

After two years of visits, Mom and Sata have learned a lot: “We can’t say enough about what Gauansé has done for us!” Together, they’ve learned about how hand-washing can prevent colds and why it’s imperative that their children sleep under bed nets treated with insecticide to ward off malaria-carrying mosquitoes. Recently, Gauansé showed Mom and Sata how to mix oral rehydration solution using water, salt, and sugar to give to the children when they have diarrhea. This simple drink has saved millions of lives around the world by keeping children hydrated until their illness passes.

Assured that Sounkara and Drissa are healthy, Gauansé waves goodbye and sets off once again down the streets of Sikoro, eager to see the next family in her care.

As she walks through Sikoro, backpack full of supplies slung over her shoulder, Gauansé continues to think through what her job means to her. “The work has helped me to be more financially independent,” she says proudly. “It has also taught me the importance of prevention in health care in keeping costs low and keeping the children of family and friends in the community healthy.”

When Gauansé arrives at Mariam and Kane’s house, she finds the women and their children outside, the mothers working and the children playing on this beautiful Bamako day. The women gather their kids and sit down with Gauansé. Two year old Bakary, sitting in his mother Mariam’s lap, seems a bit unsure about this visit today. Three year old Kadara, though, looks perfectly at ease.

Gauansé has covered many different health topics with Mariam, Kane, and the other mothers she visits as a community health worker. Like the rest of our team, she adapts the topic of her health education lessons throughout the year to address the most relevant topics at any given time — like hygiene during flu season. One theme is consistent, though: when a child is sick, they need care right away. “We’ve learned to take quick action when our children show symptoms of illness and go to the doctor before it gets worse,” Mariam explains.

After Kane, Mariam, and their children, Gauansé visits two year old Douada, one year old Aisha, and their mother Aramata, who shares, “The most important thing I’ve learned form Gauansé is how to prepare and store nutritious food in a safe way that keeps my children healthy.”

Over the next few days, Gauansé will check in on Alou, his sister Aminata, and their mother Adam; Assanatou, who is several months pregnant; Arabin, whose mother Assan is so eager to learn, she’s been seeking out health education since before her daughter was even born!; and finally two year old Rokia and her mother Sirantou. At each house, she’s greeted with a smile.

At the end of a long day of visiting with children and their mothers, taking more temperatures than she can remember, and having wide-ranging conversations about families’ health and healthcare, Gauansé heads home. But she’ll be back out here tomorrow, visiting more families because her work is never done. She is an incredible friend, provider, and advocate for the women and children in her care, and we are immensely grateful to have her on our team. Thanks for following along with her. And thank you for helping to make her work possible.

Links:

 

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Organization Information

Mali Health Organizing Project

Location: Durham, NC - USA
Website:
Facebook: Facebook Page
Twitter: @malihealth
Project Leader:
Mali Health
Westminster Station, VT United States
$88,269 raised of $150,000 goal
 
1,150 donations
$61,731 to go
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