Over the last months the world has become aware of the disaster that is taking place in West Africa. Culprit: the Ebola virus. Besides the horrifying consequences for the population – so many people dying, social structures and family ties disrupted, overstressed health services, collapse of the economy – it also showed the weaknesses of the health system in West Africa: it had little to no response to the outbreak. It is key that health systems in the countries bordering the three affected countries will be strengthened to “be prepared”. One of these countries is Mali.
Mali at risk?
KIT has a long history in working in Mali. Jurien Toonen, senior Health advisor: “We immediately looked for ways to support strengthening of health systems in Mali to adequately respond to potential cases of Ebola. This resulted in designing a 6 month pilot project in the area bordering with Guinea. The project is implemented by Malian KIT-associates of CGIC and Caritas.
Cordaid funds and supports this project while KIT provides technical support from Europe. The project prepares the Malian population and health services for a scenario in which Ebola knocks on their door. Mali has a long border with Guinea, where over 5.500 Ebola cases have been confirmed – so, Mali is at risk! Eight cases have already been detected, till now the epidemy is fortunately under control. But that could change.”
Preventive action: local communities key
To prepare the population for a potential outbreak, 50 “community sentinels” are set-up, consisting of community members who are trained on how to recognize Ebola, how to deal when a suspect case has been identified, how to avoid spreading of the disease and how to take measures of quarantine. The team members are trained to inform their community on preventing the disease – involving community and religious leaders, spreading the news through local radios.
Additionally communication channels with health services are set-up to speed up action when needed. Health services get concrete support from Cordaid in the form of equipment and materials to protect themselves and the population in case an Ebola patient needs to be hospitalized. They are trained how to implement existing Ebola protocols – they are prepared now how to take care of a patient, how to protect themselves, and last but not least: how to identify the patient’s contacts.
KIT Health has successfully supported Mali and Malian NGO’s in developing its national “results based financing” (RBF) approach. Since 2011 – it has become the national approach. RBF aims to improve the performance of actors in health system by using available resources more effectively. For example: the community members of the community sentinel and health staff will be paid based on results: the number of education sessions, the number of households visited, the number of suspected cases rightly identified, the quality of the services available to care for an Ebola patient. Evaluations suggest that RBF can improve health service delivery better than traditional input financing mechanisms since they are more successful in motivating health workers, to respond better to local needs and demand, therefor hopefully making future Ebola interventions more successful.
Local solutions, strategic support
With this project, KIT Health uses it strengths: instead of intervening directly by its experts with boots on the ground to combat, it works through its partner network in West Africa, and supports these with strategic and technical advice.
KIT additionally supports health systems by advisory services, action-research and training health staff, locally, via e-courses and through a masters’ program at KIT.