When Beatha Mukabucyana’s children fell sick with malaria, a community health worker treated them at home in her village. “The quick and efficient health services provided to me in my time of need motivated me to become a community health worker myself,” she said.
Beatha, a 46-year-old mother of eleven, now serves the Karambi Village of the Nyamasheke District, Rwanda, as a community health worker. In Rwanda, the entire population of 12.9 million people is at risk for malaria. Beatha’s district borders Lake Kivu in western Rwanda and has some of the country’s highest incidence of the deadly disease. But she didn't feel confident treating for malaria because she lacked training in handling suspected malaria cases. “At such times, I felt helpless,” she added.
That changed when Beatha participated in a 4-day training program on integrated community case management supported by the U.S. President’s Malaria Initiative (PMI) through the PMI Impact Malaria project. Integrated community case management (iCCM) is a strategy to extend the management of childhood illness beyond health facilities so that more children have access to lifesaving treatments. iCCM relies on community health workers to deliver care for childhood illnesses, including malaria.
Community health worker, Ms. Beatha Mukabucyana, works on her clients’ medical records and displays a blister pack of antimalaria treatment. Photo by PMI Impact Malaria Rwanda.
During the training, Beatha learned to confidently diagnose and treat malaria cases. “The training was not only an opportunity for me to learn, but also to get answers to all the questions that I encounter while carrying out the duties of a community health worker,” she said.
While visiting families in her community, she sees up to 20 suspected cases of malaria per month, four to ten of which test positive for malaria. Before, her community had to travel long distances to receive the care they needed. “I used to be disheartened seeing sick children and their parents walking long distances to seek care,” she said.
Now, Beatha brings health care services to their doorsteps. She joins a network of over 58,000 community health workers across Rwanda that not only make health care services for children more accessible for the communities they serve but can help alleviate the burden placed on sometimes already stretched health facilities.
Athanase Ntihinyurwa, head of Kamonyi Health Center, one of the regional health centers, shared that community health workers have helped reduce the number of malaria cases handled by the health center. From January to June 2021, the health center treated 63 positive cases of malaria while community health workers treated 687 malaria cases directly in the community. In PMI Impact Malaria’s two iCCM supported districts in Rwanda, Nyamasheke and Rusizi, providers at health centers treated 20,651 patients while CHWs treated five times more: 103,768 patients. In 2021, 80% of malaria cases were treated in the community in the iCCM supported districts compared to 56% at the national level.
Proper training plays a critical role in ensuring that Beatha and other community health workers can deliver quality and timely care to their neighbors and extend the reach of health systems beyond brick-and-mortar health facilities, bringing care closer to the those who need it most.
Community health worker Ms. Beatha Mukabucyana (left) reviews client records with her mentor, Ms. Salima Mukeshimana (right). Photo credit: PMI Impact Malaria Rwanda.
PMI Impact Malaria is funded and technically assisted by the U.S. President's Malaria Initiative (PMI) and is led by Population Services International (PSI) in partnership with Jhpiego, Medical Care Development International (MCDI), and the Malaria Elimination Institute (MEI) at UCSF.
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