Imagine a world in which pregnant women and little kids get regular home visits from a health worker — and free health care. That’s the ground-breaking approach that’s being adopted in one of the world’s poorest countries: the West African nation of Mali.
A nurse from the country’s cadre of community health workers visits each of the homes in her designated area, which contains roughly 1,000 people, at least twice a month. She diagnoses, treats and refer patients. It’s part of a free door-to-door health-care plan that began in 2008 as a trial by the government.
When data from seven-year trial was compiled by a team including researchers from the University of California, they found that child mortality for kids under age 5 dropped by an astounding 95%, according to findings published last year in BMJ Global Health. The population in the study area was 77,132 in 2013. During the seven years of the study, child mortality rates for that demographic fell from 154 deaths for every 1,000 live births in Yirimadio, among the worst in the world, to 7 – comparable to the 6.5 figure in the U.S.
And now the program will be extended to the entire country. President Ibrahim Boubacar Keïta announced a target date of 2022 for nationwide coverage — at a cost of $120 million. This localized, free health care for pregnant women and children under age 5 could help the West African nation meet the U.N. Millennium Development Goals. A key factor will be the provision of community health care workers who’ll be trained to do the door-to-door work.
The decision has earned praise from policy experts and patients alike. “This is long overdue,” says Dr. Eric Buch, a medical doctor and professor of health policy and management at South Africa’s University of Pretoria, who was not involved in the study. “Free health care for mothers and children under 5 is a very effective way of reducing mortality, and it could have a huge impact.”
The key to long-term success is long-term funding. Mali’s planned reforms rely on external funding from bodies such as the Clinton Health Access Initiative to supplement government spending. But there is no guarantee this funding source will last in future decades, and Mali will need to find a long-term solution that may involve restructuring its budget.