By Mark Young
MADAROUNFA, Niger, and KITA, Mali, 18 April 2012 – Globally, diarrhoea, pneumonia and malaria are the main killers of children, accounting for more than 40 per cent of child deaths. And in certain countries of sub-Saharan Africa, these diseases kill an even greater proportion of children. In Niger and Mali for example, diarrhoea, pneumonia and malaria cause 60 per cent of deaths among children under age 5, and malnutrition is an underlying cause in one third of child deaths.
|VIDEO: UNICEF reports on a programme to train community health workers to provide life-saving services in the hardest-to-reach places in Niger. Directed and photographed by Michael Crook; written by Michael Crook and Nicholas Oliphant. www.michaelcrook.com Watch in RealPlayer|
And access to treatment for these illnesses has been a major barrier to reducing child mortality.
This is why UNICEF and the Canadian International Development Agency (CIDA), through a partnership known as the Catalytic Initiative to Save a Million Lives, have supported Integrated Community Case Management (ICCM) of diarrhoea, malaria, pneumonia and acute malnutrition.
This community-based strategy uses trained, supervised community health workers living in areas without access to medical facilities to deliver life-saving health services to the children who need them the most.
Equity in practice
“ICCM is a direct translation of the equity strategy into practice…reaching out to the poorest…the most disinherited,” said Khaled Bensaid, Chief of Child Survival at UNICEF Niger. Scaling-up effective child survival strategies like ICCM in remote areas has contributed to a 34 per cent decrease in the under-5 mortality rate since 2005.
Marcel Rudasingwa, UNICEF Representative in Mali, said, “Today, we estimate that 41 per cent of the Malian population lives more than 5 km away from a primary health care facility. For this reason, a great proportion of the population of this country does not have access to basic health services. In order to reach this population, which is among the poorest and most vulnerable, it was necessary to put into place this strategy based on essential curative services at the community level.”
|UNICEF reports on a programme to train community health workers to provide life-saving services in the hardest-to-reach places in Mali. Directed and photographed by Michael Crook; written by Michael Crook and Nicholas Oliphant. www.michaelcrook.com Watch in RealPlayer|
UNICEF and CIDA have also supported ICCM training for 2,000 community health workers in Mali since 2011. With this new cadre of health workers deployed in the most rural and deprived communities, Mali is poised to significantly reduce the number of children who die there every year.
Reducing communities’ vulnerabilities
UNICEF is also using the ICCM approach to address the unfolding humanitarian crisis in the Sahel region, where drought, poor harvests, rising food prices and conflict have left a million children under age 5 at risk of deadly malnutrition.
ICCM is being used to strengthen health systems, build the resilience of communities, and improve capacity of governments, service providers and community leaders to mitigate the effects of the crisis and manage health risks.
By increasing access to life-saving services, UNICEF is making communities less vulnerable in the face of these kinds of emergencies. And by promoting key family practices such as exclusive breastfeeding, hand-washing with soap, and appropriate care-seeking behaviour, UNICEF is helping build the capacity of individuals and communities to address the underlying causes of malnutrition and child mortality.
Review of Systematic Challenges to the Scale-up of Integrated Community Case Management