Bringing Health Services to Rural Communities
By Alisha Rodriquez
Maté Mint Sidi Ali says she never envisioned being a leader in health. But when Counterpart International came to her village in Mauritania’s Guidimakha region recruiting volunteers to serve as Community Health Workers, she jumped at the chance.
For many rural communities in Mauritania, access to health care is a significant challenge.
The nearest health post, which provides only basic services, is six miles from Maté’s village. For most communities, without vehicles, transporting sick people to receive care is a major hardship – hiring a ride is expensive for people with limited incomes, and the alternative is an all-day trek that takes them away from income-generating activities or caring for children. As a result, many health problems go untreated and become severe or chronic.
“Access to health care is important for people’s well-being,” says Romain Kenfack, head of Counterpart’s operations in Mauritania. “Having basic health services available in the community reduces mortality and morbidity, while also reducing health expenses that households can now direct to more productive investments.”
After a series of four training sessions in basic preventive health care, disease management and peer health education methods, Maté began helping her neighbors by encouraging them to adopt improved health behaviors and providing them with treatment for basic ailments. She says bringing health care directly into the community has had an enormous impact on community health.
Before she became a Community Health Worker, Maté says, many of her neighbors suffered from malaria or fever, and small children frequently had diarrhea from drinking contaminated water and from poor household and community sanitation practices. Now, Maté leads peers in health education sessions.
These help them prevent and recognize the symptoms of common diseases, improve hand-washing and hygiene practices, identify the signs of high-risk pregnancies, promote improved breastfeeding and child nutrition, and seek care from higher-level health professionals when necessary.
This knowledge has translated into better disease prevention and management that has reduced the incidence of ailments that previously plagued the community. According to Maté, this has reduced malnutrition rates in children – which she measures during regular community-wide growth monitoring and promotion sessions – and enabled adults to work and earn money to support their families without interruption from illnesses.
Maté also helps treat basic conditions with her own supply of medicines. Counterpart provided Maté with a basic medical kit that allows her to test for and treat malaria, provide oral rehydration salts and antibiotics for children with diarrhea, and handle other simple medical issues. For more complex cases, she refers people to seek treatment at the nearest health post and follows up to make sure they recover.
Maté takes a basic fee for the medicines she provides and restocks them from pharmacies in the nearest city. In addition to bringing needed treatment to her village, Maté’s medical box earns her about 6,000 Mauritanian ouguiya – or $20 U.S. – every month to supplement her family’s income.
Counterpart has trained Community Health Workers in 160 communities. Like Maté, they provide basic health education and services to villages remote from health posts.
Counterpart has also provided training for Trained Birth Attendants (TBAs) whose skills help to reduce complications and death during pregnancy as well as pre- and postnatal care. After starting as a volunteer Community Health Worker, Fatima Mata Li attended a month-long training program from Counterpart to become a volunteer Trained Birth Attendant in 2009. Fatima delivers approximately 10 babies per month and has had to evacuate only one mother for an emergency delivery since she began as a TBA.
Fatima was recently recruited by the Ministry of Health to become a full-time, salaried birth attendant for her community and neighboring villages, and she looks forward to starting her eight-month training program in May.
“I would like to go further,” Fatima says, grateful for Counterpart’s support in starting her career in health care. “Maybe one day I can become our village’s full-time nurse.”