"The team of Project Muso has used malaria prevention and treatment as a battle horse to enter into the larger battle against poverty, structural violence and ill health... Muso team members have shown that even in a desperately poor place, community engagement in health, removal of user fees and other barriers to health care, and the assistance of the public sector in delivering care can have transformative effects on health and society." ~ Dr. Joia Mukherjee, Partners In Health Chief Medical Officer

Project Muso's Community Based Malaria Program is a community-led system for malaria prevention and treatment. We are working to eliminate deaths from malaria in Yirimadjo, and to sustain that elimination by strengthening the primary health care system as a whole. We have three principle strategies:

1. Community Health Workers provide home-based diagnosis and treatment
2. A Solidarity Fund removes financial barriers for the poor
3. Strengthening Clinical Infrastructure builds capacity to meet increased demand.  

A Project Muso community health
worker accompanies a young patient to the health center.

 

Why malaria? Although it is a preventable and treatable disease, malaria in Yirimadjo is a primary cause of suffering and death, accounting for 63% of healthcare demand. Although Mali's government has invested in  malaria medicine and bednets for children and pregnant women, growing evidence indicates that this is not enough to achieve malaria control. Effective healthcare delivery systems must be tested and scaled up to ensure that community members access and use these powerful interventions.

People don't seek care because they have malaria, they seek care because they feel sick. When high quality primary health care is available and accessible, communities develop increased trust in the health system, which results in increased use of primary care as well as earlier treatment for specific priority diseases such as malaria. 

Specifically, we aim to reduce child mortality by 50% by surpassing national targets of:

• 85% of children younger than five years receiving an effective antimalarial within the first 24 hours of symptom onset
• 85% of pregnant women and children younger than five years sleeping under a treated bednet
• 85% of pregnant women effectively taking malaria prevention medications

Health Impact

In the program’s first 2 years:

• Fever prevalence in children younger than five years decreased from 46% to 26%;
• The percentage of children treated for malaria within 24 hours of their first symptom tripled from 14% to 45%;
• Health care use increased 136%, from 11,056 to 26,135 health center visits/year.

Increasing early access to care

Stopping preventable deaths from malaria is within our reach. It requires a sustained, forward-thinking strategy that systematically removes economic, geographic, informational, and social access barriers, and builds health care system capacity.

The program gains its strength by employing locally trained and well-supervised Community Health Workers, partnering with established health delivery systems, and mobilizing the community to run the program. We believe that lasting change will occur when community members fuel the changes in care, and are supported by partnerships with existing health systems and structures.