More than one thousand pediatric doses of artemisin-based combination therapy arrived at the Yirimadjo Health Center in June 2007, to be distributed free of charge to children with malaria under the age of 5. This new policy is a crucial step by the Malian Ministry of Health.

A three-day course of artemisin-based combination therapy can cure malaria, which continues to be a leading cause of child death in Mali. And yet in the months after these life-saving drugs arrived at the Yirimadjo Health Center, their use has been minimal. The current policy provides a plan that goes as far as getting these drugs to Community Health Centers, but what then? What is the system for ensuring that these life-saving tools get from the clinic, up the unpaved dirt roads, and into the homes and hands of all those who need them most, particularly those who are poorest, most vulnerable, and most marginalized from the health system?

To systematically overcome each access barrier that people in Yirimadjo face, we are preparing to launch a Community-Based Malaria Program. This program, which we are developing with the Yirimadjo Health Center, will create a community-based delivery system for bednets that prevent malaria infection and ACT treatment that cures it, ensuring that these tools get to those who need them most, and are used effectively. This system for delivering malaria prevention and treatment tools will also lay the groundwork for delivering other life-saving health resources and care, with the aim of strengthening the health system as a whole.  

Preparations are already underway for this program, scheduled for launch later in 2008. In 2007 only one member of the clinical team had been trained in rapid diagnostics and ACT use, so our partners at the Yirimadjo Health Center requested our support in organizing a training for the entire health team, so that each member had the necessary skills for using rapid diagnostic tests and providing care with ACT. Earlier this month, Project Muso and the Yirimadjo Health Center held an introductory training in malaria rapid diagnostics and ACT treatment for the Health Center clinical team--this is the first of many trainings planned for the coming year. Insufficient training is by no means the only barrier to delivering ACT treatment, and our preparations are taking a multi-faceted approach to overcoming each barrier that stands between this therapy and the people who need it. More to come on other elements of the Community-Based Malaria Program. In the meantime, here are some images from the rapid diagnosis and ACT treatment training.