Source: IPS
“We no longer need to go to Hanène, three kilometres away, for vaccinations or for a check-up for our children,” said Maguette Niang, a 40-year-old mother from Keur Madaro, a village in the west of Senegal.

Keur Madaro is one of many Senegalese communities that now has staff watching over the health of the village from a community health post – a simple two-roomed building right in the heart of the village.

This is thanks to a five-year project launched in 2006 under the title Wër (meaning “good health” in Wolof) being carried out jointly by the Senegalese Ministry of Health, the United States Agency for International Development (USAID), and the non-governmental organisations Plan International, Child Fund, World Vision and Africare.

These partners are equipping the community health points and supplying them with medicine, in order to ensure primary health services are readily available to those who need it.

“The project has led to positive changes with respect to people coming in more frequently to seek advice or to get health care. The awareness campaigns that we carry out on malaria, acute respiratory infections, tuberculosis screening, other illnesses, as well as family planning are regularly heeded by the community,” says Djiby Faye, a community health worker at Ndioukhane Sérère, in Thiès (in the west of the country).

Faye credits the health posts with improving the skills of community health workers to handle treatment of some common ailments. “One no longer needs to go to see the head nurse to treat malaria, at least if it’s not a serious case,” Faye told IPS.

Anti-malarial medication is free, but people have to pay for care and other medication, according to the health worker.

“This project is in the process of improving health for women and children,” says Mamadou Lamine Niang, head nurse at the health centre in Hanène, which covers 23 villages including Keur Madaro. “It allows us to strengthen coverage of health programmes in our rural community, Notto (part of the western region of Thiès), by retraining community health workers, the equipping of health posts, and the putting in place of community health educators in charge of supporting activities in the health posts.”

The community is pleased by the newfound proximity of health services thanks to the project which will reach its five-year term in June 2011.

“For many years, community members were reluctant to come for vaccinations. Now with the talks organised at the health posts, people are more and more attentive to their health,” confirms Sophie Diouf, a resident of Keur Madaro.

“We give immediate care. People get a consultation and care right here,” says Abdou Seck, Wër project supervisor for the Notto zone.

“One can’t say the the Wër project has attained its objectives because there is still much left to do despite the effort,” says the nurse Niang.

He pointed to the absence of mid-wives and nurses, which leaves the vital area of maternal and neonatal health an area of concern. Speaking in her personal capacity, Dieynaba Niang, a community health educator for Plan International, said the health posts are not yet adequately staffed with qualified personnel – nurses and midwives – to support births.

Niang agreed, stressing that both homebirths and deliveries at the health posts are forbidden by the Senegalese authorities who consider it unsafe.

Niang notes with dismay the re-emergence of malaria due to a lack of insecticide-treated mosquito nets, the slow functioning of health posts which are not always completely equipped, and persisting weaknesseses in the skills of community health workers who are not especially well-motivated”.

In addition to awareness campaigns for certain diseases, health workers put on talks for women, to popularise family planning and ensure regular check-up to monitor early childhood development. But this essential work is carried out by poorly-paid agents.

The community health workers are volunteers and are not paid out of the budget; the health system only provides them with basic training necessary for their function.

“We want to have our skills strengthened. We are not motivated and by way of pay, we get just 10 to 20 percent of the receipts from the sale of drugs,” says Faye.

“Moving around [in the course their duty] is difficult for the community educators due to a lack of transport. The effectiveness of this project of community health is limited, because the health centres which must support the local health posts are left stranded,” explains Niang.

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