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Tsiraiky Abotono has never taken a vacation.
Day after day, for 15 years, he has kept watch over his village, Andravindahy, in southwest Madagascar. Abotono, 56, is one of the thousands of community health volunteers who provide basic health care services to the country’s rural areas.
His absence would be missed. To reach a health center, people would have to walk for two hours across cactus fields under a burning sun.
“It can be a challenge when I’m busy with personal duties and have to leave the village. The population relies on me entirely for health matters,” Abotono says.
Like other community health volunteers, he provides short-term family planning methods, prenatal care, and diagnosis and treatment of simple cases of diarrhea, pneumonia, and malaria.
A Boost From Mobile Technology
Despite its remote location, Abotono’s village is on the cutting edge of mobile health technology.
In 2016, USAID and the U.S. President’s Malaria Initiative helped Madagascar’s Ministry of Public Health develop and roll out an app to improve the quality of community health services.
The CommCare app is particularly effective for the detection and treatment of malaria. It allows health workers and volunteers to more easily and effectively identify and report cases of malaria to public health officials.
This is a critical advantage for Abotono.
Malaria is a main cause of death in Madagascar, especially among young children in remote areas. In Abotono’s village, more than 80% of the 300 children he saw in the past eight months tested positive for malaria. With help from the app, he ensured each of them received the proper treatment and followup to beat it.
“MY ONLY DREAM IS THAT NO ONE WILL DIE FROM MALARIA IN MY VILLAGE.”-ABOTONO
Through the app, Abotono receives step-by-step instructions on using rapid diagnostic tests.
“When somebody brings a child with fever to me, the app walks me through the process. It tells me to check the child’s overall health status and prompts me to do a rapid diagnostic test for malaria,” Abotono explains. “If the test result is positive, the app indicates the treatment that I should provide.”
Community health volunteers can also access digital forms via the app that feed into the national health reporting system, quickly relaying information to public health officials and simultaneously informing the distribution of essential supplies to prevent shortages.
Facing The Challenge Of COVID-19
When COVID-19 came to Madagascar’s shores, USAID’s ACCESS health program led by Management Sciences for Health introduced an update to the app – adding a COVID-19 module.
Now, the same app lets Abotono conduct contact tracing and education activities aimed at preventing COVID-19. “Having this innovative tool in my hands helps people trust me. My village has been spared by COVID-19 so far, but we are ready to face this challenge, and I feel very lucky to be able to contribute to the pandemic response activities.”
ABOUT THIS STORY
Shrewd health system investments, like placing the CommCare mobile health app into the hands of trained local health leaders and workers, can improve health services in remote areas.
The use of the CommCare app has helped keep malaria services accessible and reliable, despite the COVID-19 health crisis. Since April 2020, no complex cases of malaria have been recorded in Andravindahy, in part thanks to the prevention and timely detection and treatment of mild cases.
More than 1,000 community health volunteers and 146 health centers currently use the app in three of Madagascar’s 22 regions. The Government of Madagascar plans to have 5,000 health workers using the app by 2023, and USAID ACCESS, led by Management Sciences for Health, and the U.S. President’s Malaria Initiative will support the rollout as part of efforts to help Madagascar sustainably grow and improve its community health system.
DELETE Mobilizing Against Malaria: New app places remote Madagascar village on cutting edge of mobile health technology is written by WDG Team for msh.org