A look inside a Community Health Worker’s bag: used to deliver care
Muso CHW's carry Artesunate suppositories in their backpacks. Due to national stock shortages of this item at the times of this photo was taken, the suppositories are not pictured in the photo.
Community Health Workers (CHWs) conduct daily proactive visits to patients’ homes. While out in their communities, they encounter patients in need of care. Time matters when treating illness and disease, which are most easily treated when caught in the earliest stages. To provide care effectively, all Muso CHWs are equipped with necessary medical supplies. These supplies, combined with the speed, training, and local expertise that a CHW delivers, are critical to providing the right care for the right patient at the right time.
Inside every backpack are medications for treating malaria, pneumonia, diarrhea, and malnutrition and providing family planning services, along with necessary sanitary and hygiene tools used when conducting check-ups.*
Take a look at the supplies CHWs use on a daily basis to test and treat common illnesses in Mali
The Malaria Diagnostic and Treatment Package:
In Mali, malaria poses an enormous risk to health and well-being. Malaria remains a global killer, claiming over a quarter of a million deaths of children under 5 years in 2018. However, in the sites where Muso serves, febrile illness among children under 5 has significantly declined.
If a patient is showing symptoms like a high fever, vomiting, chills, and/or diarrhea, CHWs’ backpacks contain items both for testing malaria and treating simple cases of the disease. Specifically, the kit contains rapid diagnostic tests and the necessary tools for determining whether to administer a test, such as a thermometer for checking for high fevers. If a patient is diagnosed with malaria and requires treatment, CHWs carry artemisinin-based therapies and artesunate suppositories for simple cases of malaria. On an average day, a CHW may treat between 2 and 5 children for malaria.
The Pneumonia Care Package: In 2018 alone, there were 13,000 pneumonia-related deaths in children younger than five in Mali. At the community level, Muso’s CHWs are equipped to treat pneumonia with a simple yet vital combination. The pneumonia kit includes a thermometer to check for high temperature, amoxicillin to serve as an antibiotic to treat lower respiratory tract infections, and paracetamol to reduce fever and relieve any pain. Paracetamol can also be used to treat a multitude of other diagnoses, like reducing fever.
The Diarrhea Treatment Package:
CHWs carry supplies for diarrhea, a common yet deadly sickness if not treated. Muso CHWs carry zinc as well as oral rehydration salts to treat diarrheal diseases. Diarrhea is a global killer of more than 2,100 children each day, more than AIDS, malaria, and measles deaths combined. Giving a zinc supplement has proven to be a critical intervention for children with diarrhea, and research suggests that zinc paired with oral rehydration salts can reduce these episodes for months.
The Malnutrition Care Package:
47% of children in the Bankass region where Muso’s rural sites operate are malnourished – the highest rate in Mali. Child malnutrition can have far-reaching effects on child health and development, economic security, and well-being. This is why all of our Community Health Workers provide proactive diagnosis and treatment for children with malnutrition as part of their package of care. The supplies CHWs carry include the Mid-Upper Arm Circumference (MUAC) malnutrition band to test for malnourishment in children between six months and five years old, enriched flour to restore lack of iron and B vitamins, albendazole for deworming, and folic acid as a nutrition supplement. For more severe cases, the CHWs also carry Vitamin A supplements. CHWs check for malnutrition by wrapping the MUAC band around each child’s arm at least one time per month. A child’s malnutrition level is determined by the width of their arm, as measured on the colored lengths of the MUAC band. Children who test positive for moderate acute malnutrition begin treatment immediately in the home and receive proactive recovery support and follow-up from their dedicated CHW.
The Reproductive Health Package:
In 2015, Muso launched our integrated Proactive Reproductive Health package, adapting our proactive approach to catalyze progress on women’s reproductive health. In Muso’s preliminary data set, our research team found that over the course of 22 months, the use of contraception and more effective types of contraception significantly increased from when we first started the intervention in the peri-urban district in which we work, Yirimadio. In the context of Mali, a proactive approach to reproductive health is especially important, given the country’s high fertility, low rates of family planning utilization, and barriers that exist in accessing family planning and facility-based care. When it comes to family planning and reproductive health, our CHWs are equipped with a rapid diagnostic test for pregnancy as well as various types of birth control, including oral contraceptives, Depo-Provera injections, and condoms. Our CHWs build trust with each patient through door-to-door proactive pregnancy testing, family planning services, and accompaniment, reaching women earlier with life-saving reproductive health services.
Muso aims to meet patients where they are with the right tools for diagnosis and treatment. CHWs go door-to-door stocked with supplies to prevent and treat illnesses most prevalent in the communities Muso works. Having these items available in a patient’s home not only brings accessible and necessary care right to someone’s doorstep; it works to strengthen the health system as a whole- the fewer people get sick, the fewer people have to seek more intensive clinical treatment. In turn, the whole health system benefits from having fewer patients admitted, resulting in healthier families and communities overall.
CHWs keep their backpack stocked with these items year-round. Ensuring these supplies are available and in stock is a function of Muso’s 360° Supervision model. One of the key steps in the 360° Supervision model is having a monthly group supervision meeting with all CHWs where Supervisors can ensure restocking of supplies.
A Muso CHW stocks up on the supplies she carries in her backpack during a monthly group supervision meeting with her CHW Supervisor.
Many major illnesses can be prevented, or treated before severity increases, with simple, proactive check-ups from trained CHWs. When necessary, the supplies our CHWs carry can adapt to the needs of the community. For example, family planning options were added to Muso’s package of care after CHWs heard the need of the communities they served firsthand. More recently, Muso began equipping CHWs with personal protective equipment (PPE) in the midst of the novel coronavirus outbreak. Removing barriers to care and equipping our CHWs with the necessary tools and a robust delivery system allows patients to reach quality care, and regain their health, faster.
*Though not part of a CHW’s regular kit, all CHWs are equipped with personal protective equipment for the duration of the COVID-19 outbreak in Mali, read more about our COVID-19 response here.