Mali community case management
In 2010, Mali approved a National Community Health Strategy (Soins Essentiels Communautaires) which includes an integrated community case management (iCCM) package for malaria, acute respiratory infections, and diarrhoea.
Community health centres
There are 1,513 community health centres, which each cover a population of 5,000 inhabitants within a radius of 15 km. They a minimum package of activities in the areas of patient consultation (including the management of malaria, HIV, AIDS and TB cases), vaccination, antenatal consultations, assisted deliveries, postnatal consultations, monitoring of child health and family planning, and malnutrition care.
Community health workers
Community health services are provided by community health workers (CHW/Agents de Santé Communautaires) at the village and household levels. These CHWs also provide primary care to newborns and some family planning services to eligible families. The National Community Health Strategy and CHWs are supported by an additional cadre of community health volunteers, the relais, whose role is to carry out social and behaviour change and health education to promote key health messages to complement community activities, including iCCM.
The National Community Health Strategy recommends that CHWs be placed in villages located five kilometres or more from a health facility, that they cover two to three villages in a radius of three kilometres, and have a catchment population of approximately 1,500 people, whereas relais typically cover just one village. Mali currently has 3,253 community health worker sites, of which 3,104 are operational, covering a total population of 9,146,736 inhabitants living more than 5 km from a community health centre.
In addition, Global Fund COVID-19 grant funds will be used to bring on 1,200 new CHWs and to support the training/upgrading of CHWs on the management of malaria, which is being integrated into the community health package. Support for the Government of Mali plan for nationwide implementation of the National Community Health Strategy and the iCCM package, which includes supervision, commodities, RDT confirmation, and quality assurance/quality control, and social and behaviour change communication is incorporated into the most recent Global Fund grant.
Severe malaria case management
Severe cases identified in the community are referred to the Centre de Santé Communautaire or community health centre (CSCOM), where they can receive appropriate treatment by a community health worker (an Agent de Santé Communautaire; ASC or community health workers). CHWs use pre-referral interventions (artesunate rectal capsules) and refer the patients to the community health centres.