In Pibes, a small village in the center-south of Burkina Faso, all mothers know the court of Elizata Congo. Whenever their child has a fever or cough, they knock on his door to seek his advice. The young woman is only 26 years old and has her elementary school certificate in her pocket, but residents already call her “Lafi Naba”, the “head of health” in Moray.
Alizeta Congo has been working as a community-based health worker for six years (ASBC). In addition to cultivating the land, she cares for newborns, children, and the mothers of her village. “Sometimes they take me to the field or wake me up at night. I have to be available all the time.”Elizata explains Congo, who was trained by caregivers.
In a country where there was one doctor for every 10,000 residents in 2019, the authorities are relying on support recruitment to fill staff shortages and improve access to care in the most remote villages. To guide these volunteers, who will be able to read and write, Burkina Faso, in partnership with UNICEF and the Global Fund to Fight AIDS, Tuberculosis and Malaria, has created a mobile application for digitizing data called “mHealth”. The purpose is to improve patient care and follow-up, as well as control of drug stock sites.
About 17,000 assistants have been recruited
Every morning, Alijeta Congo wakes up before the first rays of the sun, at around 4:30 am, after making breakfast for her three children, the young woman sets her counseling table under the old mango tree in her house before going to the field. . He does not count his time.
“I’m happy to help my community”, This emphasizes the farmer, who, as a child, dreamed of becoming a nurse “Save the Children” Of his village. “When they get sick, we prefer to infuse them rather than take them to the clinic.”Regret for the latter, who dropped out of school at 4 p.m.e.
In Burkina Faso, the infant mortality rate is still high, with 82 deaths per 1,000 live births. Malaria, respiratory infections and diarrhea are the three most deadly diseases in children under 5 years of age. More than two in three deaths occur at the community level and many of them could have been avoided through rapid treatment.
To address this, the authorities adopted a national community health strategy in 2018 and recruited about 17,000 helpers in the country’s isolated villages of 21 million inhabitants. The latter plays a relay role between the nursing staff and their community. They diagnose and treat common cases of childhood illness and transfer serious pathologies to the nearest health center.
On each visit, Alizeta Congo creates a file in the mHealth application and answers a questionnaire. The program then diagnoses the disease and prescribes the prescribed treatment
Sitting on a tree stump in her filthy backyard, Alijeta Congo embraces her patients amidst the pleasing ballet of picking chickens and tap-taps of drumsticks. Put in front of him, a medicine box and his mobile phone, which he no longer separates. On each visit, he created a file in the mHealth application and answered a questionnaire. “Does the baby have a warm body? Can she drink or breastfeed? AHe falls on his screen. Once the form is complete, the program diagnoses the disease and prescribes the prescribed treatment.
“Common malaria, one tablet morning-evening three days”, Advises the platform, in a message illustrated with explanatory drawings of the small sun and moon. Free care for children under 5 and pregnant women is part of the free care policy introduced in Burkina Faso since 2016. mHealth also shows the stock of drugs found in his village.
The application, which works offline, then transfers the data collected by SMS to a secure server, which is accessible to municipal health centers, health districts, regional management and central level teams. Even if the system is not faulty – Alizeta Congo sometimes encounters problems with the telephone network or lacks access to an electrical outlet to recharge its laptop – it represents significant progress.
Eight kilometers through the bushes
“Previously, the patient’s register would have been lost and the paper would have been lost. With the application, it’s faster and more reliable, we can test the work of field agents and be alert if there is a drug shortage. “, Explained Arsene Da, head of health promotion in the provincial capital, Kombisiri. Sometimes Alizeta made a Congo diagnostic error or forgot to ask questions during the consultation. As a precaution, he often prefers to refer certain patients to communal health centers. Apart from that, if you want to go there, you have to travel about 6 km through bushes.
“Most women have to ride or ride their bikes”, Elizetta Congo, who also goes home to monitor the pregnancy and care for the newborns. And in the rainy season, from June to August, when there is an outbreak of malaria, the track that leads to the masses is regularly flooded and becomes inaccessible.
“Because of the distance, we lose the sight of some patients, others prefer to practice self-medication, but if they are not taken care of quickly, patients run the risk of complications, sometimes serious.”, Says Henriette Loué, the nurse in charge of the public dispensary, which covers seven villages, including Pibse. Here some patients have traveled ten kilometers from time to time to seek advice. The center’s only ambulance tricycle is being dismantled, its crews have to call a motorcycle taxi when they have to evacuate a patient urgently, to the commissary.
Since 2022, fifty health workers have been equipped with a phone and using the pilot phase of the mHealth app Counting in the district, fourteen ASBCs treat an average of one hundred patients per month in their villages. “It gives us comfort, they allow our dispensary to open a bit.”Henriette Loué admits, overwhelmed by the regular patient arrivals, up to four hundred per month, for six attendants.
In twenty years, the incidence of HIV epidemic has decreased by 90%, reaching 0.7% of the population in Burkina Faso.
In the face of disease and epidemics, Burkina Faso focuses on prevention. In twenty years, thanks to the solidarity of the association and various awareness and screening campaigns, the country, which has become an example on the continent, has succeeded in reducing the number of HIV infections. In twenty years, the epidemic has decreased by 90%, reaching a rate of 0.7% in the population.
Several times a month, Alijeta Congo rides her bike and goes from hut to hut for leadership. “Educational Discussion” With family “Photo box”. HIV transmission methods, contraceptive methods, family planning, diet… we talk about everything, although there are still many restrictions in Burkina Faso society. By force, Alizeta has become Congo “Trusted” The women of his village. “They come to see me whenever they have a problem.”For a monthly salary of 20,000 CFA francs (about 30 euros), he delights in treating thirty patients a month.
Purpose: To cover all villages
It participates in malnutrition screening, vaccination monitoring, mosquito distribution campaigns and patient tracking. “Missing”. At the height of the Covid-19 epidemic, ASBCs were instrumental in advising on barrier gestures.
By 2023, seven regions should have mHealth systems, representing about 7,500 health workers. The long-term objective is to cover all villages located more than 5 km away from a health facility. According to estimates modeled by the Ministry of Health, the community outlook will prevent about thirty thousand newborns or maternal deaths next year.
In addition to saving lives, data digitization helps strengthen the efficiency of the national health system. “Having real-time information makes it possible to identify and prevent epidemic risks and thus quickly adapt public health programs. We have a health memory that makes the medical picture more precise and improves the diagnosis for the treatment of children. “Sandra Lattuf, UNICEF Representative in Burkina Faso, made the analysis “Adults are trusting me more and more and asking me to treat them now! AAlijeta Congo laughs.
Summary of our dossier on AIDS in Africa: A time of hope
This article is part of a dossier produced as part of a partnership with the Global Fund.