Social innovation brings hope to Mali slum

mhopGandhi, pioneer of voluntary action and social innovation in modern India, famously said, “it is health that is real wealth”. Health is widely recognized as a key concern for NGOs working in the poorest areas of the world. Sadly the marriage of health care and social innovation is rarely seen among large NGOs and international health organizations. The lack of long-term solutions and the failure to address root causes of problems can mean the failure of seemingly well-intended aid projects. So the importance of a health organization that seeks to provide social innovation for lasting change cannot be underestimated.

The Mali Health Organizing Project (MHOP) is an NGO that provides healthcare to some of the poorest people of Mali. The project was conceived by Caitlin Cohen, Erica Trauba, and Lindsay Ryan. They founded the project when they were students studying at Brown University, Long Island. Originally they went to Mali to work on an HIV study with a Brown University professor. As a result of the field trip Cohen, Trauba and Ryan became interested in applying the past work they had done on community organizing and social innovation in the US to a community health project in Mali. In 2006 they returned to Mali and started conducting formative research, interviewing local leaders, and establishing partnerships. In 2007 The Mali Health Organizing Project was officially incorporated as a US registered nonprofit. They have been developing the project ever since.

Mali is the third poorest country in the world. Health needs in Mali are enormous: nationally 1 in 5 children die before their fifth birthday mostly from preventable illness such as diarrhea. The organization works with people living in one of the country’s fast-growing slum neighborhoods. In the slum communities people live in especially deprived conditions. They occupy precarious housing structures with either poor or non-existent sanitation, limited access to clean water and electricity and lack of security of tenure (ownership of land or property rights). Disease travels fast and slum dwellers suffer from poor health. Basic services, such as education and healthcare, are poor or in many cases not available. As informal settlers, slum dwellers have very few rights and so struggle to make a case for help with the authorities. Social innovation is needed as much as direct aid. Fortunately MHOP uses it’s unique approach to provide both.

So far MHOP has established a community clinic, expanded access to primary healthcare, increased community governance, and promoted individual empowerment. One of MHOP’s social innovation projects is the Action for Health initiative, a program which provides in-home health care and health education for women and children. Instead of charging user fees, which deter the poorest from seeking care, MHOP charges "action-fees." All adults must participate in three health actions per year. These vary from community trash clean up days to tree planting campaigns to malnutrition awareness events. This way, MHOP helps create economic, social, and political capital without demanding cash from people who cannot afford to pay. MHOP also intensively trains local residents in simple primary care and health education techniques. Community Health Workers visit families twice monthly, evaluating each child's health. When a child is sick, the Community Health Worker accompanies the family to the clinic, ensuring that the sick child receives care. To ensure that children get the care they need, MHOP covers the cost of treatment for the 5 leading killers of children under the age of 5 (diarrhea, malnutrition, malaria, acute respiratory infections and measles), as well as health emergencies.

MHOP tracks participation in the Health Actions project, as well as collecting health data. They have conducted a baseline health survey, and their Community Health Workers collect data on basic health indicators (height, weight, temperature) during home visits. They use specially designed cell phones that allow them to text data back to a central server at MHOP’s clinic, creating electronic medical records that help with program M&E and also support doctors in effectively treating patients when they come in for treatment. Currently 400 children use the Health Action program. Depending on funding MHOP hopes to double the program next year.

Photo credit: Mali Health Organizing Project

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