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A Simple Community Health Remedy in Mali A Simple Community Health Remedy in Mali
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Deploying community health workers to treat sick children rapidly can make an enormous difference in how many live and how many die, according to a new study done in Mali.Deploying community health workers to treat sick children rapidly can make an enormous difference in how many live and how many die, according to a new study done in Mali.
The focus neighborhood of 56,000 people — Yirimadjo, on the outskirts of the capital, Bamako — had a 90 percent drop in deaths among young children from 2008 to 2011, according to the study, published online by PLOS One last week.The focus neighborhood of 56,000 people — Yirimadjo, on the outskirts of the capital, Bamako — had a 90 percent drop in deaths among young children from 2008 to 2011, according to the study, published online by PLOS One last week.
That confirms what has been seen in many countries, from Rwanda to Bangladesh: Community health workers, even with modest training, can save many lives. In Yirimadjo, they were trained to recognize 16 danger signs, to go house to house looking for sick children and pregnant mothers, and to treat malaria on the spot.That confirms what has been seen in many countries, from Rwanda to Bangladesh: Community health workers, even with modest training, can save many lives. In Yirimadjo, they were trained to recognize 16 danger signs, to go house to house looking for sick children and pregnant mothers, and to treat malaria on the spot.
The lead author, Dr. Ari D. Johnson of the University of California, San Francisco School of Medicine, said the study showed that delivering health care to children rapidly and at home made all the difference in saving lives. Many local women could not afford clinic fees, or could not leave home without their husband’s permission.The lead author, Dr. Ari D. Johnson of the University of California, San Francisco School of Medicine, said the study showed that delivering health care to children rapidly and at home made all the difference in saving lives. Many local women could not afford clinic fees, or could not leave home without their husband’s permission.
It is unclear how practical the Yirimadjo model is. During the study, with money that poured in from charities and the Mali health ministry, a new clinic was built, water pipes were installed, and residents received free medical care.It is unclear how practical the Yirimadjo model is. During the study, with money that poured in from charities and the Mali health ministry, a new clinic was built, water pipes were installed, and residents received free medical care.
Also, the population of the neighborhood swelled during the study period, making comparisons of different years’ figures imprecise.Also, the population of the neighborhood swelled during the study period, making comparisons of different years’ figures imprecise.
But Dr. Johnson argued that the additional expenditure amounted to only $8 per resident per year. When added to the $45 per person Mali normally spends on health, he said, that is “well within the range” of normal health spending in Africa — less than is spent, for example, in Rwanda and Senegal.But Dr. Johnson argued that the additional expenditure amounted to only $8 per resident per year. When added to the $45 per person Mali normally spends on health, he said, that is “well within the range” of normal health spending in Africa — less than is spent, for example, in Rwanda and Senegal.
And the benefit was so great, he said, that the increase in population could not have skewed the results very much. DONALD G. McNEIL Jr. And the benefit was so great, he said, that the increase in population could not have skewed the results very much. 
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