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Reducing infant mortality in the Koulikoro region

Carte KoulikoroSome 2.5 million people live in the Koulikoro region of southern Mali located between Mauritania and Guinea. The prevalence rate of severe acute malnutrition in children under five was over 2% in 2010, 2011 and 2012 (source: Unicef, 2012 SMART National Survey). Koulikoro is considered one of the four Mali regions most at risk from malnutrition.

While malaria is the primary cause of mortality of children under five in the region, malnutrition increases the risk of death in children affected by other childhood pathologies.

Alima and AMCP in partnership with the Ministry of Health co-ordinate a project offering free treatment of malaria and malnutrition in an effort to reduce infant mortality. The program operates in six of Koulikoro’s health districts.

Alima and AMCP have been working in the Kangaba health district since May, 2011 and in Kolokani and Ouelessebougou districts since June, 2012. They also began working in 2013 in Dioila, Fana and Koulikoro districts. The project covers over 1,420,000 people.

Access to care is difficult in all districts. Despite the many working community health centers, over half the population lives more than 5 km from a health facility. The situation is especially aggravated during the rainy season when the roads become impassible just when the prevalence of malnutrition and the spread of fever-related diseases hit their peak.

Mortality of children under five is heavily impacted by these difficulties of access and the lack of medical wherewithal in rural areas. According to the WHO, the mortality rate of children under five in rural areas stands at 234 per 1,000 as compared to an average of 178 per 1,000 in all of Mali (WHO, the 2012 World Health Statistics Report).

In an effort to reduce infant mortality in these six Koulikoro districts Alima and AMCP provide support in medical, human and financial resources in various health facilities and support the implementation of a community workers network.

Such an approach enables the screening and treatment of malnutrition in each of the districts at the following three levels:

·        At the village level community workers systematically screen children under five for malnutrition. Trained, advised and supported by Alima-AMCP teams, they screen and refer children with severe acute malnutrition to community health centers

·        Support is given to the community health centers to enable them to treat children with the uncomplicated forms of severe acute malnutrition and malaria

·        The most serious cases are referred to and hospitalized in referral health centers where Alima and AMCP provide strong support to the URENI (Recovery Units and Intensive Feeding Education) and pediatric departments in order to provide free quality treatment to children with severe acute malnutrition and malaria with complications

By including these two public health issues in the same integrated, decentralized approach, it is possible to provide treatment that is adapted to children under five.

 

Our activities in figures

2013 forecasts

Treatment of over 17,500 children with SAM and over 114,000 malaria cases

Funded by Unicef and ECHO