Malaria in Mali is the main cause for doctor’s visits and mortality. According to a demographic and health-related survey, more than 2.6 million confirmed cases were registered in 2018, representing 39% of consultations in public health facilities and killing about 1,000 people. This figure is believed to be not all inclusive, according to the national malaria control program, as it does not include people who prefer to see a traditional doctor or those who visit private facilities.
Significant reduction in mortality
In order to control the parasite, “we concentrate on the agents who themselves come from the communities,” says Dr. Idrissa Cissé, director of the National Malaria Control Program in Mali. In addition to communicating with their relatives, whom they listen to and advise, the agents are able to provide certain basic health services based on World Health Organization (WHO) protocols. “They can treat simple cases of malaria or, if they find it too difficult, refer the case to the nearest health center,” says Cissé.
A total of around 3,000 municipal health workers are distributed in Mali and offer free health care. “This is not enough to cover the entire country,” stresses Idrissa Cissé. More than half is financed by the Global Fund $61.5 million for the period 2019-2021 and used by non-governmental organizations. Since the inception of the program at the beginning of 2010, health authorities have noted a significant reduction in parasitic mortality. In 2012, 1,883 people died from 2.1 million reported cases, 800 more than in 2018.
Providing the network
The Malian government intends to maintain, if not develop, this network of social workers to support the fight against malaria. As some USAID funds run out, the United States Agency for International Development and the Malian Department of Health plan to support 375 health workers in the Sikasso and Kayes regions, the most malaria-affected areas, by 2020.
A funding round that fascinates Alfousseyni Sangaré, the permanent secretary of the Global Fund’s coordinating body in Bamako. He believes that this solution is “financially unsustainable in the long term”. Mali must think of a new approach,” he emphasizes. Now it must be ensured that the population goes to the health centers at the risk of creating a parallel health system. In his opinion, community health workers should only support health structures, not replace them in neighborhoods and villages.