Senegal

Rural health huts provide crucial care - Village-level services in Senegal boost child, maternal health

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Patricia Awa Sarr got malaria, but she was lucky. In another place, in another time, she would have been forced to walk for hours with a high fever or hail a donkey cart for a sandy trek to a district health post. There a nurse would, hopefully, have enough time to treat her before things got worse.

Patricia, however, needed only enough strength to reach the health hut in her village of Sinthiou Mbadane where a qualified volunteer community health worker diagnosed and treated her.

"After the consultation, the community health worker gave me drugs and explained to me how to use them," says Patricia, a 28-year-old pastor's wife and mother of four. "He asked me to take the first drugs in his presence to see if I understood the explanation, and I did."

Then he gave her advice about malaria prevention and advised her to sleep under an insecticide-treated mosquito net. Later she approached a community health educator attached to the health hut and chipped in $2 for a USAID-subsidized bednet.

USAID and several of its implementing partners, including Christian Children's Fund (CCF), have had significant success through various programs in making treated bednets more available to those who need them most. Currently, the various partners are teaming up to distribute free nets in districts with low net ownership, and a USAID-subsidized voucher system in other districts, allowing people to choose a net and contribute a small amount as co-payment for it.

The CCF program also trained community health workers in the treatment of malaria in villages, using the latest and most effective medicines. In addition, an education and communication campaign encourages pregnant women and young children to sleep under bednets and helps mothers, grandmothers, and community members recognize the symptoms of malaria.

"The project has helped my community have drugs and insecticide-treated mosquito nets when needed, which facilitates our health care and gives us means to prevent malaria," says Patricia. "As for me, I have recovered my good health and I follow the advice given to me, using the nets."

Bringing health care to remote villages improves the lives of mothers and children, and that is why USAID has made it a main focus of its health activities in this West African country. Malaria is the leading cause of death for pregnant women and young children in Senegal, but malaria prevention and care is just one service the healths huts, through USAID assistance and training, provide.

To improve access to basic health services, USAID and CCF implemented a community-based health program in three rural districts in the Mbour Department. They set up 140 health huts and worked with the local population to select volunteer community health workers. In total, 1,300 health workers birth attendants were trained so that mothers and children can access a wide array of health services right in their community. These range from treatment of malaria, of respiratory illnesses and wounds to preventive services such as growth monitoring and disease prevention.

In addition, USAID and CCF encourage nurses from the nearby towns to pay monthly visits to each health hut and offer services such as immunization, prenatal and postnatal consultations, and other services the volunteer community health workers are not trained to provide.

"Before receiving care at our health hut, diseases like malaria, diarrhea, and acute respiratory infections often claimed the lives of children and even adults," notes Ndèye Niang from Ndiarmew village. "Women faced many difficulties trying to get to the health post for prenatal check-ups, delivery, post-delivery check-ups, and children's immunization."

But such complications are becoming fewer as many health services are now available right where people live. According to Fatou Ngom, 18, the health of the children in her community has greatly improved as a result of the USAID-funded project. Her two-year-old was seriously sick with diarrhea, and the community health worker at the health hut in Keur Balla Lo gave her oral rehydration salt, advised her to breastfeed more often and feed her with porridge and milk, butter, and peanuts at least three times a day. "Two days later Khady started again to play with other children," she says. "Now she is very healthy."

This program, and similar ones implemented by other USAID-supported groups, was so successful that USAID has now begun supporting such activities in 27 districts in five of Senegal's regions.