CHW Scale-Up Designing to Achieve and Sustain Impact

GLOBAL iCCM SCALE-UP

33 35

28 31

6

28

05

10152025303540

Malaria Diarrhea Pneumonia Malnutrition NewbornIllness

iCCMNum

ber o

f Afr

ican

Cou

ntrie

s

Rasanathan et al, 2014

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

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%20Web.pdf Accessed 2015 Sep 22.

Child Mortality With Pro-CCM

PROACTIVE COMMUNITY CASE MANAGEMENT

Proactive Search

Doorstep Care: CCM

Rapid-Access Health Centers

Care without Fees

360° CHW Supervision

CHW Dashboard

CHW Dashboard

Mali’s National CHW Scale-Up

Recommending 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

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