Reducing maternal and child mortality rates through proactive healthcare
Locations Served
Mali, Cote d’Ivoire, Zambia
Budget
$16,000,000
Partner Since
2020
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Problem
Billions of people in developing countries continue to suffer from infections, malnutrition, and maternity-related health risks, which have long been controlled in rich countries.
Research on labor force issues identifies health workers as the key ingredient to successful health systems, but worldwide the health workforce availability remains at less than 10% of what is needed to deliver essential primary health care services. While the shortage is global, it is felt most acutely in low-income countries, regions where the highest disease burden have the fewest health workers per capita. There is currently a health worker shortage of seven million nurses and doctors in rural areas of Africa.
Mounting evidence over the last twenty years shows that community health workers (CHWs) are a cost-effective solution; sometimes they provide the first and only access to health services in remote areas. They also offer the added benefits of being from the community in which they serve and reducing the need for difficult or expensive journeys to healthcare facilities. The World Health Organization (WHO) estimates that expanded access to key CHW interventions can prevent an additional three million deaths per year. But research makes it clear that the mere availability of a health workforce is not sufficient. Health workers must be equitably distributed and accessible, must be competent and empowered to deliver quality care that is appropriate to the culture, and must be adequately supported by health systems.
Programs Offered
Muso currently employs a cadre of 560 CHWs to treat patients at the earliest signs of illness using a three-step model:
- Proactive door-to-door visits
- Doorstep care with life-saving screenings and medicines
- Rapid access to strengthened clinics by removing fees and other barriers to entry
CHWs bring critical services into the home, provide on-the-spot treatments, and refer acute cases to the next appropriate level of care–all free of charge. Their services include family planning, newborn screening, and treatment for children with malaria, diarrhea, and malnutrition.
Supervisors lead CHW group discussions to solve common challenges and reinforce key skills, gather feedback from people served, shadow each CHW once a month, and provide one-on-one feedback to improve performance. At the clinic level, Muso improves the quality of care by building the capacity of medical staff and making crucial infrastructure upgrades.
Founded in Mali in 2005, Muso has built strong partnerships with the government in Mali and Cote d’Ivoire to design, test, deliver and scale strategies for rapid, universal health care across direct service sites in both countries. Muso provides training and salaries for CHWs and CHW supervisors in addition to providing government health center staff training and operational support, referral and evacuation costs, medical supplies, and pharmaceuticals.
In 2024, Muso announced a third country partnership with the government of Zambia, focused on strengthening the national health system by embedding
Muso’s technical assistance experts within key departments of the Ministry of Health.
Historical Results
Since 2008, Muso CHWs have delivered care through 18,602,528 cumulative home visits and 1,830,485 cumulative clinic visits for nearly 600,000 patients across Mali and Cote d’Ivoire. More than 90% of sick children under age five are reached by CHWs within 24 hours of symptom onset.
Independent research has demonstrated extraordinary outcomes in the communities Muso serves. A 2017-2020 study conducted on Muso sites in rural Mali showed the child death rate plummeted by more than 40% as communities were provided with free health care, professional CHWs, and upgraded primary care clinics. Findings were published in the June 2024 edition of The Bulletin of the World Health Organization (WHO) and demonstrated the largest and fastest improvement in child survival ever recorded in a conflict zone.
Results from a 2018 study of Muso’s CHW performance improvement through 360° supervision demonstrated a 78% increase in number of home visits, a 20% increase in speed of care, and a 33% increase in quality of care.
A 2008-2015 study on peri-urban communities served by Muso showed that three years after the introduction of Muso CHWs, child mortality decreased 10-fold. Early access to care increased nearly two-fold and the total number of patient–provider contacts increased 10-fold. At baseline, under-five mortality was 155 per 1000 live births. After three years, it was 7 per 1000 live births—a rate comparable to the U.S.
Path to Credibility
- Muso’s founders and dedicated original team members are still active in the organization. Nine out of 13 members of the leadership team are Malian.
- Despite being a small organization, Muso is achieving outsized, unquantifiable impacts through its considerable research, dissemination of best practices, and collaboration with other programs.
- Findings from a 2013 study on Muso’s CHW intervention model—conducted by Muso, UCSF, Harvard and the Malian Ministry of Health—focused global attention on ultra-rapid healthcare delivery and made Muso’s approach a global model for saving children’s lives. As a result, the Malian government asked Muso to provide intensive technical assistance in creating a five-year strategic plan to scale-up paid, professionalized CHW’s throughout the country.
- Member of the Community Health Impact Coalition (CHIC), a coalition of 32 healthcare nonprofits from 60+ countries formed to promote quality Community Health Worker (CHW) programs and to make professionalized CHWs a standard form of care worldwide. Muso’s long-term government collaboration serves as a model for many CHIC members of varying sizes. Its strong partnership with the Malian Ministry of Health has survived two coup d’états, Ebola outbreaks, and terrorist activity.
- FP has conducted two field visits to Muso in Mali and Côte d’Ivoire.
- FP and Muso have conducted four successful matching campaigns.
→ Visit the current Muso campaign page