Assistance Technique Nationale: A National Health Program

• Program Overview
• Objectives
• Outputs and Results

PROGRAM OVERVIEW

The Keneya Ciwara Program aims to improve the survival of Malian mothers and children through interventions that emphasize high-impact health practices.

USAID provided funding for this five-year effort. Initiated in October 2003, this comprehensive health communication program intervenes at every social level, shaping national level policies, improving regional and district coordination, and enhancing village level access and service. The implementing partners include ABT Associates (Prime), Helen Keller International, IntraHealth International, IBEX, and Social Sector Development Strategies (SSDS).

OBJECTIVES

The program’s goals all relate to High Impact Health Services. For maternal health and child survival, such services include family planning, reproductive health care, immunization, nutrition support, malaria prevention, diarrheal disease control, and health reform. These national objectives focus on improving the policy environment, quality, access and demand for all these services. The strategy is two-fold: 1) Build national capacity through policy support and health care provider training, and; 2) Increase demand for services using mass media and community mobilization.

OUTPUTS AND RESULTS

Capacity building began with the development of a national reproductive health communication strategy. With this strategy in place, the program developed a wealth of training and communication materials on each high impact area. Training curricula, tip sheets, radio and television spots, radio dramas and more are instantly accessible on the Reproductive Health & Child Survival in Mali CD. Distributed across the country’s Communication, Learning and Information Centers, this collection features a remarkable variety of technical, training and media tools on six topics: family planning, immunization, reproductive health, nutrition, malaria and child survival.

Because service quality depends on well-trained health care providers, the program reinforced the education providers received. Curricula on contraceptive technology and interpersonal communication were developed for doctors, nurses and midwives. Alternative curricula emphasizing prevention were designed for outreach workers. Both groups were trained using these curricula. Visual aids, cue cards and flipcharts were designed to help health workers explain unfamiliar concepts. A message guide helped to unify and harmonize messages about High Impact Health Services. Schools, literacy centers and Communication, Learning and Information Centers received these tools to disseminate health messages to the widest audience possible.

Mass media programs in a variety of formats have proven successful in stimulating consumer interest and demand for services. A fourteen-episode radio series in Bambara, the country’s most widely spoken language, used an entertainment approach to familiarize people with High-Impact Health Services. Another radio drama, this one on immunization, was broadcast in eight episodes and five languages. Both radio and video addressed malarial prophylaxis (IPT). Two-part radio programs were broadcast in nine languages. Three video spots on malaria prevention during pregnancy also reached TV audiences. Press briefings and media outreach ensured radio and television coverage of high-profile program events such as launches of family planning, Vitamin A and malaria campaigns.

By August 2006, the program already recorded some significant achievements.

1. Nutrition: Over 2 million children and 65,000 women have received Vitamin A supplements.
2. Community Education: Outreach workers have contacted 1.5 million people through community and household education
3. De-Worming: During the pilot phase alone, 250,000 children have received de-worming treatment.
4. Malaria Prevention: 191,889 treated nets have been distributed
5. Reproductive Health: 145,074 pregnant women have registered for prenatal care
6. Family Planning: 40,578 new clients have adopted modern contraceptive methods
7. Training: 60 supervisor/trainers, and 80 providers have completed training on interpersonal communication and contraceptive technology.

The program is implementing other high impact health service interventions at the regional level, described in the Keneya Ciwara Regional Level Health Program article.