CHW Scale-Up: Designing to Achieve and sustain Impact

1. CHW Scale-Up
Designing to Achieve
and Sustain Impact

2. GLOBAL iCCM SCALE-UP
33
35
28
31
6
28
0
5
10
15
20
25
30
35
40
Malaria Diarrhea Pneumonia Malnutrition Newborn
Illness
iCCM
NumberofAfricanCountries
Rasanathan et al, 2014

3. BURKINA FASO ETHIOPIA MALAWI
Utilization Rate of
CHW Services
Low: No significant change Low: No significant change Low: No significant change
Under-Five Mortality
Rate
No significant difference No significant difference No significant difference
NATIONAL iCCM SCALE-UP: 3 RECENT STUDIES

7. 2008 2011
155
17
Source: You D, et al, on behalf of the United Nations Inter- agency Group for Child
Mortality Estimation (2015) Levels and Trends in Child Mortality: Report 2016.
Available:
http://childmortality.org/files_v20/download/IGME%20Report%209_8%20LR%20We
b.pdf Accessed 2015 Sep 22.
Child Mortality
With Pro-CCM

9. PROACTIVE COMMUNITY CASE MANAGEMENT
Proactive
Search
Doorstep Care:
CCM
Rapid-Access
Health Centers
Care without
Fees

10. 360° CHW
Supervision

11. CHW
Dashboard

12. CHW
Dashboard

13. Mali’s National
CHW Scale-Up

14. Recommendin
g to Remove
User Fees
• Ineffective at cost-recovery
• Regressive: increase health inequalities, drive
millions of patients into poverty annually
• Reduces and delays utilization of care
FINANCING CHW SCALE-UP IN MALI

15. Medium Term
Bilateral and
Multilateral
Support
• Major commitment by the Global Fund signed
in February to co-finance CHW scale-up along
with USAID, UNICEF, and other key partners
Long Term
Budget
Reallocation
• Mali currently spends 5.6% of its budget on
health, but has committed through
Declaration of Abuja to increase this to 15%
Mobilizing
new tax
revenue ,
novel
financing
mechanisms
• Taxes on extractive industries (UNITLIFE), on
financial transactions, on products with
negative health effects (tobacco, alcohol,
sugar-sweetened beverages)
FINANCING CHW SCALE-UP IN MALI