How a poor community in Mali became a trailblazer for tackling child mortality

Extraordinary success of scheme under which health workers make house calls could save untold young lives in sub-Saharan Africa

Home to a large number of migrants and an even larger number of babies, Yirimadio is a heaving, ramshackle district on the outskirts of Bamako. Only a decade ago, it was a commune, much like any other on the Malian capital’s periphery. Now, though, it is the unexpected scene of a pioneering healthcare scheme. Child mortality rates here have dropped to the point where they are now the lowest in sub-Saharan Africa – an achievement that may all be down to knocking on doors.

The premise of the scheme, which launched in 2008, is simple: community health workers spend at least two hours, six days a week searching for patients door-to-door, providing free care to whoever needs it. Mali has long struggled to contain preventable infectious diseases such as malaria, pneumonia and diarrhoea. Consequently, the country has the world’s sixth highest under-five child mortality rate, estimated at 115 deaths for every 1,000 births according to the most recent figures available. But by turning conventional healthcare on its head – sending health providers to patients at no cost, instead of requiring them to seek out fee-paying medical attention – Yirimadio achieved a spectacular turnaround. Between 2008 and 2015, the child mortality rate dropped from 154 deaths to seven for every 1,000 live births.

The results are unprecedented. But that’s not what we want. We want them to be boring, normal. That’s the real challenge

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Continue reading... March 16, 2018 at 12:30PM