Health for all: putting the last mile first
10 December 2015
Universal health coverage (UHC) means that every person, everywhere, has access to quality health services without suffering financial hardship.
As we celebrate universal health coverage day and advocate for health services to be accessible, equitable and effective for all, we take a look at some of Malaria Consortium's projects taking place across Africa and Asia that work to ensure access to health for the poorest and most remote communities.
Malaria Consortium staff work across Africa and Asia to improve lives through sustainable, evidence-based programmes that combat targeted diseases and promote child and maternal health. To achieve universal health coverage, it is imperative that we prioritise the poorest and hardest to reach groups, foster investment in health and strengthen health systems. Take a look below to see how we are striving to do just this…
Fernando is a community health worker or Agente Polivalente Elementare as they are known locally in Mozambique. As part of his work, he visits remote communities in Morrumbene district, Inhambane province, that are often far from health centres, and provides basic healthcare for the most common childhood conditions such as malaria, pneumonia, diarrhoea and malnutrition. Malaria Consortium works in Mozambique and other sub-Saharan African countries to train community health workers as well as improve their motivation and retention to ensure that remote communities have proper access to health services.
We work at community level to facilitate community dialogues, which provide an opportunity for villagers to discuss health problems facing the community and come up with solutions to address them. In this photo, a dialogue brings together local residents to discuss how they can prevent malaria in their community. In this photo, a dialogue brings together local residents to discuss how they can prevent malaria in their community.
In the Sahel region, 60 percent of malaria cases occur during the rainy season. To protect children aged 3-59 months, the World Health Organisation recommends seasonal malaria chemoprevention. This intervention takes place each month of the rainy season when eligible children receive a mixture of drugs that protects them from malaria. As part of the ACCESS-SMC project, Malaria Consortium works to bring life-saving seasonal malaria chemoprevention treatments to millions of children across the Sahel. This year, over 28,000 Community Health Workers were trained to carry out mass drug distributions of SMC, visiting households to ensure that all eligible children receive this treatment that, when used alongside other preventive malaria tools, can reduce malaria cases by up to 75 percent. Community delivery of the SMC drugs means that all eligible children can benefit from this lifesaving intervention, in spite of difficult conditions brought on by the rainy season.
Drama groups provide another innovative platform to spread health messages among communities. In this photo, a community in Mbale, Uganda watches a performance that shows what to do when someone falls sick from malaria.
In Myanmar, we work with people to find positive health behaviours that already exist within communities, such as wearing long-sleeve clothing outdoors to prevent mosquito bites. The rest of the community can then be encouraged to emulate these behaviours in order to improve health and bring down cases of malaria and other diseases such as dengue.
To improve uptake of long lasting insecticidal nets, we work with campaign volunteers and mobilisers who conduct house-to-house visits to inform community members of distribution campaigns and benefits of nets, as well as to distribute net cards for women to bring to distribution points for collection. Here, a mobiliser in Nigeria walks between households to inform residents of the campaign and its benefits.
Copyright Malaria Consortium/William Daniels
The impact of malaria epidemics, common in Ethiopia, is often felt in schools. During the malaria transmission season, absenteeism is common among students and teachers. Shinshicho primary school, in the south of the country, is one of 50 project schools in malaria hotspot zones across the southern regional state of the country that has established an anti-malaria club, with the aim of tackling low levels of awareness of the disease. The project, supported by the Global Fund to Fight Aids, Tuberculosis and Malaria, was completed in 2012, but teachers at the school have been running the club ever since using the training and materials. By working with schools to bring this knowledge directly to the community, people are better able to protect their own health as well as their families’.
We also work at border checkpoints in Asia’s Greater Mekong Subregion in order to screen and treat border-crossers to ensure that the drug resistant strain of malaria is contained and eliminated. Here, a Malaria Consortium worker asks a man if he would be willing to be tested and, if he tests positive, treated for malaria.
In Ethiopia and Uganda, our Beyond Garki project works to study the changing environment of malaria. We pursue a range of methods that allow us to paint a clearer epidemiological picture of the disease. This allows us to better serve rural communities with more targeted and effective interventions.
The use of long lasting insecticide treated nets greatly reduces the risk of being infected with malaria. We work with governments, partners and the private sector in order to ensure that distributions are effective and far-reaching. Recently, Malaria Consortium led the distribution of 21 million nets in Uganda, leading to near-universal coverage.
This past year, we supported the government to conduct the first ever country-wide malaria indicator survey in Myanmar. Survey teams trekked across the country during heavy flooding to ensure that accurate data was collected, even from the hardest-to-reach areas. The results of this survey will help to prioritise malaria services more effectively to areas of greatest malaria burden and provide baseline malaria data to support future assessments of the impact of all malaria-related activities nationwide, as well as for future strategic planning.
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Keywords: Community delivery