Authors: Caroline Whidden, Amadou Beydi Cissé, Faith Cole, Saibou Doumbia, Abdoulaye Guindo, Youssouf Karambé, Emily Treleaven, Jenny Liu, Oumar Tolo, Lamine Guindo, Bréhima Togola, Calvin Chiu, Aly Tembely, Youssouf Keita, Brian Greenwood, Daniel Chandramohan, Ari Johnson, Kassoum Kayentao, Jayne Webster
The Proactive Community Case Management (ProCCM) trial in Mali aimed to strengthen the health system by removing user fees, employing professional community health workers (CHWs), and upgrading primary health centers (PHCs). Village-clusters were either assigned proactive home visits by CHWs (intervention) or fixed site-based services (control). Over three years, both groups saw a doubling of sick children receiving 24-hour treatment, pregnant women attending four or more antenatal visits, and a halving of under-five mortality compared to baseline. The proactive home visits had a modest impact on care utilization but did not further reduce under-five mortality compared to the control. The study examined why these results occurred using interviews, surveys, and clinical data analysis. Key findings showed that removing fees and deploying professional CHWs enabled quick access to care, health system support ensured quality care and increased utilization, and proactive home visits helped build trust and facilitate care. Overall, addressing structural barriers like user fees and improving healthcare facilities played a significant role in improving health outcomes.
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Resource Topic: Community Case Management
Resource Type: Randomized controlled trial
Year: 2024
Region: Africa
Country: Mali
Publisher May Restrict Access: No