Health can’t wait

New

Young children and infants still die at epidemic rates in the poorest corners of the globe. Their deaths are mainly linked to the distance, cost and poor quality of health services. Within each of these barriers and taken together, time matters: the later children get care or treatment, the more likely they are to die. For more than a decade, Muso has been working with the Malian government to change the way health care is delivered, with the aim of reaching patients in the first few hours they show signs of illness. Muso’s “proactive care delivery model” trains community health workers to go out into communities, treat sick patients in the home, and connect patients to capacitated government clinics - all free of charge - instead of requiring them to seek out medical attention. Communities where this system has been applied have observed massive improvements in child mortality from 115 to 7 deaths in every 1,000 children, which is better than any country in sub-Saharan Africa. We are funding Muso to build a technical assistance team to provide intensive support for governments, policy makers and implementers within and beyond Mali to adopt proactive community health strategies for child survival, maternal healthcare and universal health coverage.

Duration
2019-2022
challenge
Access to Basic Services
country
Mali
partner
Muso

Context

Mali has long struggled to contain preventable infectious diseases such as malaria, pneumonia and diarrhoea. Consequently, the country has one of world’s highest mortality rates for children under five (101 deaths for every 1,000 births).

Since 2008, Muso has been working with the Malian government to change how health care is delivered. In communities on the outskirts of Bamako, the country’s capital and largest city where Muso’s proactive care delivery has been implemented since 2008, child mortality was reduced by 93% in three years in the communities.

Action

Muso works to end preventable deaths rooted in poverty through a global transformation in health care delivery. Its proactive care delivery model is three-fold:

  • Proactive search: Community health workers and community members proactively search for patients through door-to-door home visits to connect them with care at an early stage. Through Muso’s 360° Supervision model, each CHW receives regular on-site mentoring and training from a dedicated supervisor, tailored to their strengths and weaknesses.
  • Doorstep care: Community health workers provide an integrated package of life-saving services in the home. These include pregnancy testing, family planning, screening new-borns and women for danger signs, and treatment for children with malaria, diarrhoea, pneumonia, and malnutrition.
  • Rapid access to clinics: CHWs identify patients needing more complex care, and accompany them to expanded government-run health centres, where Muso removes financial barriers and fees, builds infrastructure and trains staff, so clinics can provide universal, timely access to quality care.

Expected results

Our funds will help Muso to build a technical assistance team to provide intensive support for governments, policy makers and implementers within and beyond Mali to adopt proactive community health strategies for child survival, maternal healthcare and universal health coverage.

Our support will therefore contribute to Muso’s strategic goals, including:

  • Reach 450,000 patients directly in Mali
  • Reach up to 18 million patients indirectly in Mali though government implementation nationwide
  • Expand Muso technical assistance services to one additional country

Long-term strategy

Muso’s core proactive care strategies, which cost $10-$13 per capita per year in addition to existing government health spending, are designed for cost-effectiveness and government implementation at scale.

In 2019, strategies Muso has designed and tested were officially adopted by the Malian government as the foundation of the national health care reform that will be implemented over the next four years. The government has also committed to adopt Muso’s performance management system to support and evaluate community health workers.