Essential Community Care (ECC): Issue of the care of sick children by Community Health Agents (CHA) in the rural town of Sagabala, Mali.

Abstract

Introduction: Health services provided only in health facilities, in both rural and urban areas, generally do not provide access to adequate, timely and equitable care. Community case management, or Essential Community Care (ECC), removes barriers to accessing care by training and supporting Community Health Workers (CHW) to diagnose, treat and refer sick children to the community health centers in which they live. The objective was to assess the impact of the care of sick children by CHW. Methods: This was a descriptive cross-sectional study carried out between March and April 2021 in the rural town of Sagabala on 4 CHA sites, it concerned the care sheets for children from 0 to 59 months and mothers or caregivers. Results: In total, the care sheets of 281 children were examined, that is 46% attendance rate, the sex ratio was 1.3 and the average age was 32 months. Fever was the most common reason for consultation with 49.5%. In most cases, the consultation took place within two days of the onset of symptoms. Acute malnutrition was observed in 5.5% of children. Malaria was more frequent with 48%. In 90.4% of cases the diagnosis was correct with compliance with the treatment protocol (82.5%). The promotional and preventive role of the CHW was not sufficiently known by the community. Conclusion: The strengthening of community awareness on the package of CHW activities seems to be necessary for its better appropriation by the community and a real change in behavior for the well-being of the child, the woman and the family.