As a Community Health Facilitator for VillageReach in Malawi, I see the impact of Community Case Management (CMM), a strategy that promotes the early care-seeking behavior, assessment, diagnosis, recognition, and appropriate treatment for childhood illnesses at the community-level.
Over the last few years, CCM has evolved into a more comprehensive strategy that addresses the three main diseases that commonly kill young children under 5: malaria, pneumonia and diarrhea. In the model of CCM, health surveillance assistant (HSAs)—the name for community health workers in Malawi— are identified and trained in diagnosis and treatment of these key childhood illnesses. They attend to sick children in their communities, and refer those outside their competences to the nearest health centres.
Village clinics, run by HSAs, can take place out in the community at a public location, or at the HSA’s home. VillageReach is one of the organizations working in the Balaka district of the Kwitanda catchment area in Malawi, with a specific interest in promoting maternal and child health. In collaboration with the Malawi Ministry of Health, VillageReach established 17 Village Clinics in Group Village Heads Kwitanda, Mchenga and Mpilisi, and directly employs 6 HSAs like Pemphero Katondo (pictured above).
Pemphero is a VillageReach HSA from Mpilisi Catchment area who operates Jailosi Village Clinic one day a week on Fridays. One afternoon, a mother brought her 19-month-old child, Modesta, to the village clinic. She was suffering from malaria and pneumonia, presenting with fever, rapid breathing, coughing and vomiting; but it was too late in the day for the mother to take the child to the nearest health centre. Modesta was treated with the appropriate treatments of LA, Cotrimoxazole and Panado, taking the start-up doses right at Pemphero’s home.
Pemphero followed up seven days later and found Modesta feeling well, playing, her appetite restored.
“Village Clinics are really playing a great role in the community. My child’s life was saved and I was saved from the long distance I would have had to make on that day, had the village clinic not been there”
“Village Clinics are really playing a great role in the community. My child’s life was saved and I was saved from the long distance I would have had to make on that day, had the village clinic not been there,” Modesta’s mother says.
Modesta’s story is not unusual. Village clinics play a vital role in saving children’s lives. A normal village clinic day for Jailosi Village Clinic starts with the clinic opening at 9:00 in the morning. The Jailosi Village Clinic takes place outside in a designated area, but often village clinics take place at an HSA’s home. The HSA brings a drug box and a safety box to the clinic. One member of the Village Health Committee assess the children according to the seriousness of illness, referring and treating the sickest children first.
Apart from treating sick children, the HSAs talk with caregivers about how to take care of their sick child as well as the right drugs for treatment. On average, the HSA treats 33 cases a week. Pneumonia, malaria and diarrhea are the most common cases treated, but sometimes they see red eye and oedema. When the case is challenging, the patient is given a start-up dose of the appropriate medicine, and then referred to a health centre.
I am encouraged by stories like little Modesta’s, and I see how important HSAs like Pemphero are to improving community health, especially for rural communities like Kwitanda.