In early 2021, Jean Mukeba recalled, only about 40 children a month were visiting her rural health center in the Democratic republic of Congo (DRC). Then the Abt-led USAID Integrated Health Program (IHP) arrived to support Ndekesha, Mukeba’s rural health zone in Kasaï-Central province.
IHP worked with local health departments to train community health workers (CHWs), who conduct door-to-door home visits and lead public educational talks each month to help parents identify signs that their children might be sick with diarrhea, malaria, or pneumonia. In partnership with local and community health authorities, Abt supports mini-campaigns featuring community debates, “couples’ evenings,” and other activities to raise awareness about health concerns and encourage parents to take kids with “warning sign” symptoms to a health care provider for treatment.
The results were dramatic. “After the mini-campaigns,” said Mukeba, a registered nurse, “we received more than 500 patients in just a few days.”
The IHP initiative addresses a critical problem in the DRC. Lack of awareness of symptoms and poor access to health care have had dire consequences. The country’s mortality rate for children is 104 per 1,000 live births, more than double the global average.
When parents don’t know warning signs, it produces troubling results. The country’s 2018 Multiple Indicator Cluster Survey showed that only 28 percent of DRC parents sought treatment for their child’s diarrhea, 34 percent sought treatment for their child’s acute respiratory illness symptoms, and 45 percent sought treatment for their child’s fever. COVID-19 has only deepened the dual challenge of raising parents’ awareness of danger signs and boosting the quality of care at health facilities.
Those who recognize symptoms often fail to pursue medical treatment due to accessibility issues or misinformation. Instead, they use traditional healing techniques at home that are less effective. Low traffic at health facilities reflected this reality.
In its effort to address this challenge, the Abt team in the most recent Program quarter trained 196 CHWs in topics like infection control and prevention, integrated community case management, maternal and child health, and basic medical treatment. The CHWs have visited thousands of households, directly referring upwards of 2,300 children to community care sites and nearly 9,000 to nearby health facilities.
The Program also provides health centers with data collection tools, consultations sheets, and medicines to treat childhood illnesses. This includes oral rehydration salts and zinc tablets (cost-effective treatments for childhood diarrhea), first-line treatment for malaria, and antibiotics to treat bacterial infections.
While these efforts make facilities more efficient, behavior change campaigns are essential to help families detect a possible illness and access quality health services for their children. Hence the mini-campaigns. Importantly, the trained CHWs are local resources for continued awareness-raising through home visits and responding to needs for information and education in their communities.
Abt’s work extends well beyond Kasaï-Central. The team has carried out more than 100 behavior change mini-campaigns in the nine provinces where we work. Together with health workers and facilities, we are increasing demand for quality medical services. That will keep children healthy while raising the standard of care that’s available for the Congolese people.
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