Campaigning against infant mortality, malnutrition and malaria

In Mali, one in five children does not reach the age of 5.

Located in West Africa in the Sahel, Mali has more than 13 million inhabitants.  Malaria is the leading cause of mortality and morbidity in the country: 90% of the population live in exposed areas.  Malaria alone accounts for 36% of the medical consultations across the country.  It particularly affects children under 5 years old with high risk of mortality, totalling more than 860,000 victims against 780,000 in 2009 (WHO Report, 2010).  Associated with widespread malnutrition, which is rated as a chronic emergency, nearly one child in five does not reach the age of 5 years, ranks Mali sixth among the countries most affected by infant mortality.

Despite a stable situation and a real commitment from government and aid participants to improve the health situation, the country has widespread malnutrition and access to care remains inadequate.

This is the challenge that ALIMA wishes to address, in partnership with the AMCP (Medical Alliance Against Malaria), a Malian NGO already well entrenched in the Kangaba circle, Koulikoro region in southern Mali, one of the areas most affected by this two pronged scourge.

The Kangaba circle: difficult for healthcare access

Located halfway between the Guinean border and the capital, the Kangaba circle has more than 100,000 inhabitants as well as many immigrants from neighbouring countries.

Access to health facilities is difficult: more than half the population live more than 5 km from community health centres, the health facilities closest to the population.  There are 12 in the area, there are also two reference health centres in Kangaba and Sélingué, where we can treat the most severe cases.  In the rainy season, roads become impassable, while malnutrition and the transmission of diseases such as malaria reach a peak.  In these circumstances, combined with a lack of financial resources, access to care is particularly difficult for the most vulnerable populations.

Treating malnutrition and malaria: ALIMA’s interventions

In order to respond to these access to care problems, in 2005 Doctors Without Borders Belgium set up a malaria management programme, with innovative strategies such as free care or care decentralisation with the setting up of a network of community health officers who travel to the villages to ensure the detection of malaria and offer first aid.  This applies to children under 5 and also pregnant women, the most vulnerable to the disease.  However, in March 2011 the DWB Belgium project was closed, and as a direct consequence free health care disappeared, resulting in consultations being halved.

To prepare for this closure, DWB Belgium worked with national personnel, who decided to create their own NGO, the AMCP.  With the strength of its members’ humanitarian experience behind it, the Malian NGO was ready to take over the project but had to find an international partner to provide technical support and access to financing.  With this in mind, together with Alima, it opted to resume the project and go further in reducing child mortality by integrating management of malnutrition among children under 5 years old.

Since May 2011, ALIMA and the AMCP have jointly coordinated the project and distributed free and decentralised malaria and malnutrition essential care, covering pregnant women and children under 5.  Together and in partnership with various participants including the Malian Ministry of Health, over 3000 children could benefit from the programme and continue their normal growth cycle.

The setting up of the network of community health officers in villages not only provides care to isolated populations, but also enables early detection of malaria and malnutrition, thereby treating a larger number of people and avoiding complications.  The integration of these two public health problems into one comprehensive and integrated approach, enables appropriate treatment provision for children.

For treatment against malaria, patients with uncomplicated malaria are treated in the village or community health centres, while those with more complex forms of the disease must be hospitalised at the reference health centre.  For the management of malnutrition, community health officers can identify children suffering from severe acute malnutrition in the villages.  Depending on the severity of their case, they can be dealt with at community health centres or be admitted to reference health centres.  ALIMA provides support to the AMCP. in terms of human resources, training, appliances and equipment for the project.

Partnership, innovation and exchange of expertise are the driving forces of our work.  It is for this reason that in setting up the project we are cooperating with our partner BEFEN in Niger, in order to benefit from their experience in terms of malnutrition.  This exchange between two Sahelian NGOs enables reinforced skills on both sides, both in nutrition on the treatment of malaria, and also it marks a new approach to aid, where partnership shows its true value.

2011 Budget: 600,000 euro

This joint ALIMA / AMCP project is funded by ECHO and Doctors Without Borders Belgium