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It is 1 pm in Tambacounda, Senegal, and the sun is blazing hot. Famata Diarra has been waiting for almost five hours under the slim shade of the local health hut.
“I will not go home until Alpha sees my son,” she confides to another mother.
Both women are waiting to see Alpha Bâ, the only health provider in the village of Sinthiou Pagnate, which is in the middle of a dry savanna.
Today is Wednesday, so before Alpha Bâ sees Famata and her son, he will spend the first part of his day making house calls in a neighboring village that does not have a health facility of its own. Through the Pfizer-funded Mobilize Against Malaria project, IntraHealth International trained Alpha and 47 other community health workers to provide on-site treatment for malaria, immunizations, and care for acute respiratory infections. These health workers are now in charge of 24 health huts, all built or renovated over the past five years in the Tambacounda health district.
The project also trained 96 community health educators who teach mothers like Famata how to prevent malaria and keep their children healthy. To do this, the educators held community events to bring people and their health providers together for discussion. Local radio stations aired messages about malaria treatment and prevention to some 70,000 listeners.
Now word has spread. For example, when Mobilize Against Malaria started in 2007, only 15% of the population surveyed in Tambacounda knew that artemisinin combination therapy (ACT) was the best treatment for a child with fever. By 2011, when the project began wrapping up, 49% knew that ACT should be administered in all cases of fever.
Mobilize Against Malaria worked with community partners and stakeholders to improve or reopen the 24 health huts, all of which were either unused or underused due to poor quality or lack of infrastructure.
Health huts (or cases de santé, as they’re called in French) are the lowest tier of the Senegalese health system. Some 58% of Senegal’s population lives in rural areas, and the huts—run by community health volunteers—are the main source of health services there. Health huts are also the most underfunded and understaffed of all public health facilities. Resources, equipment, and training are often in short supply. No one knows just how many health huts are currently operational since they don’t appear on the health facility map.
The Mobilize Against Malaria project has worked with local communities, providers, health committees, and officials to revitalize health huts in three ways: 1) by remobilizing, training, and motivating community health workers; 2) by making health committees more functional; and 3) by equipping health huts with essential medicines, equipment, management tools, office furniture, and basic supplies.
The project also solicited support from the communities and health workers themselves in order to make health huts self-sufficient. Local volunteers, health committees, and others used seed money from the project to start small income-generation projects and used profits from consultation fees and medicine sales to fund the huts.
“Some communities improved their health huts and the services that were provided beyond Pfizer’s support,” says Lamine Guèye, IntraHealth’s representative in Tambacounda. “Such community efforts will help us build on what Mobilize Against Malaria started.”
Health providers in rural Senegal will now be better equipped to provide care for patients like Famata Diarra and her son, and to those in neighboring villages who do not have health huts of their own.