Mali community case management
Community health centres (CHC): run by community health workers (CHWs) and community health volunteers.
- Managed by Community Health Associations (ASACO) who carry out treatment, awareness-raising and preventive activities.
- Clinical Integrated Management of Childhood Illnesses (IMCI) replaced by home-based treatment (HBT) for malaria treatment in Mali
- HBT: community health volunteers and relatives within the household treat malaria
Community Health Workers / Agent de Santé Communautaire (ASCs)
Receive refresher training every 3 months and supportive supervision on a regular basis
- Paid a salary of ~$100 per month (supported by various donors)
- Continued funding a concern
- 1 CHW needed per 1,500 inhabitants in a 3km radius and in a zone located over 5km from a health center
- 1 volunteer needed per 50 households
- 2014: 2,437 CHWs present (49.9% coverage) in 5/8 of country
- 3,092 new volunteers trained on early referral of severe cases.
- 2,600 new CHWs need to be recruited
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 know as an Agent de Santé Communautaire (ASCs).
- CHWs use pre-referral interventions (rectal artesunate capsules) and refer the patients to the CHCs
- The Government of Mali (GoM) is also revising its community strategy (called ‘SEC’ locally), to reduce donor costs and to incorporate cost recovery into the program with a goal of sustainability over the long term.
- Regular payment of incentives to CHWs
- CHW integrating themselves into communities
- Drug stock outs
- Coverage in certain zones on account of insecurity
- IEC/BCC and interpersonal communication capacities
- Retaining CHWs at their site
- CHW supervision