| ||Dr. Emanuel, left, talks with expectant mothers.|
ChildFund’s leadership of a community-based health project in Senegal is saving lives and lifting the quality of health care for children and families. Malaria cases are down, child nutrition is up and maternal health care is steadily improving.
These successes are a result of long-term work to mobilize communities and train volunteers on key health practices. With funding from USAID, ChildFund is leading a consortium of organizations to implement the Programme Santé, Santé Communautaire (PSSC) health project nationwide in Senegal. More than 4 million people have benefited.
Working hand-in-hand with Senegal’s health districts, ChildFund and its partners ensure that families have easy access to more than 1,350 local health huts run by trained volunteers who live in the community. The health huts, with a special focus on maternal and child health, oversee prevention and treatment of basic illnesses, refer serious cases to the nearest government health facility and promote health education for the entire community. Mobilized Community Health Committees help ensure ongoing citizen involvement.
USAID Administrator Dr. Rajiv Shah visited PSSC health huts this past June. That same week, speaking at the National Press Club in Washington, D.C., Shah cited the health huts as an example of cost-effective and sustainable local capacity-building to ensure the offer of “basic but life-saving interventions to women or children who have health needs” or referrals to the government health system.
In October, Ezekiel Emanuel, M.D., Ph.D., special advisor for health policy, White House Office of Management and Budget, visited the PSSC Bouthie health hut in the Kaolack district, which provides health services to approximately 1,600 people. His goal was to become better acquainted with various USAID-funded health projects and talk directly with community leaders who provide health services.
The visit focused on the health hut’s basic, life-saving services related to maternal and child health, such as treatment of malaria, diarrhea, pneumonia and malnutrition and reproductive health. Given the project focus on local ownership, partnerships and capacity-building, Emanuel wanted to hear from the community itself, including health volunteers.
Emanuel’s questions were probing. Reading from the statistics and graphs posted on the health hut wall, he asked about decreases in malaria and malnutrition. One of the community health volunteers, Djiby Faye, explained that malaria is down in this community because health volunteers counsel families to sleep under bed nets and keep areas surrounding their homes free of standing water to prevent mosquitoes from breeding. Cases of simple malaria, identified with rapid diagnostic testing, are treated with a combination therapy known as ACT.
Accounting for the community’s declining rates of malnutrition, the health hut’s focus on early growth promotion ensures that mothers are aware of and prepared to respond to potential nutrition problems before their children become malnourished and require treatment at health facilities. Malnutrition-prevention activities integrate prevention of diarrheal disease and micronutrient deficiency. Child growth monitoring serves to identify, treat and/or refer malnutrition cases.
“Anyone here sick enough to go the hospital?” Emanuel queried. Yes, just the previous day Faye said he had referred a patient with a persistent headache and fever to a district health post. This link between community health huts and the Ministry of Health network of government-supported health facilities helps ensure that patients receive escalated levels of medical care as needed.
Community health volunteers like Faye are placed under the administrative direction of communities (e.g., a Community Health Management Committee) and the technical direction of Senegal health districts and ChildFund Senegal.
As Faye shared how the health hut is effectively treating diarrhea with oral rehydration solution (ORS) and zinc, Emanuel asked, “Did you teach the mother to do anything?”
Teaching mothers how to better feed and hydrate children when they have diarrhea is a key focus of the local Community Health Committees established under the PSSC, Faye responded. Community health volunteers also stress to mothers the importance of preventing diarrheal disease by promoting hand washing.
As Emanuel’s visit concluded, he commended the health hut’s overall efforts yet urged them to strive for continual improvements. The ultimate goal is to provide sustainable and affordable access to basic health care that prevents disease and saves lives.