Malaria, pneumonia and diarrhea are most common causes child morbidity and mortality in Niger. World Vision as an international faith based and child focus organization could not stay indifferent to this cause of child death. As a result, it decided to partner with World Health Organization (WHO) who launched the RAcE programme in 2015 in five African countries - Democratic Republic of Congo, Malawi, Mozambique, Niger, and Nigeria - in 2013 to implement iCCM (Integrated Community Case Management) approach.
In Niger the project is called NICe-RAcE (Niger Integrated Child Health) which seeks to expand on the gains made under the Catalytic Initiative and rollout of by extending iCCM to households (beyond 5 km of a health facility) through community health volunteers (referred to as Relais Communautaire or RCom).
My dream is to become the first village doctor but for that to come true I know that I need more qualifications and practice in this field.
According to the NICe-RAcE second annual project report in June 2015, 831 trained RComs have received 153,201 sick children whereas among them 120,083 were treated from malaria, pneumonia and diarrhea.
Two weeks ago I had the privilege to meet a very especial RCom. When I met Aminou Moumouni, I found him in front of his house in an improvised space called “Hangar”, he arranged to receive his patients. That day was a very busy one for him but he was kind enough to give me a few minutes of his precious time to share his story. “I became an RCom when the village committee chose me and after passing the test of iCCM training provided by trainers from District Hospital and Chiefs of Health Centers in December 2013. Since then I have screened and treated more than 300 children in my village. My dream is to become the first village doctor but for that to come true I know that I need more qualifications and practice in this field,” Says Aminou Moumouni, a 30 years old RCom of Kourfan Tsaouna village 7 kilometer from Dogondoutchi town.
Aminou Moumouni adds, "initially people in the village were not sure if I could really treat their children. Very few parents use to bring their children but overtime the number and the frequency increased. Today I don’t even have time to go to the farm. Almost every day I either have to follow up a case or see a new one”
While I was there Zouera Soumaila, a mother of 5 children, brought her son Almoustapha (age 2) for a follow up. “When I first saw little Almoustapha he had malaria and pneumonia. After treatment with ASAQ 25mg/67.75 mg and with amoxicillin 250mg, his health has improved considerably,” says Aminou with confidence.
“In the past I had to walk 7 kilometers to reach the health centre and then wait for long hours for my child to be seen by a medical staff. Now I have this service at my door step with the guarantee that my children will receive drugs and better treatment,” says Zouera Soumaila smiling and holding little Almoustapha.
"Since Aminou Moumouni started his work, we never received a cases of malaria, pneumonia and diarrhea in children (with ages between 2 to 59 months) from Kourfan Tsaouna village. The RCom reduced our work load at the Integrated Health Centre. RComs are well training and equipped to do their job. For example each RCom has in his box a stock of drugs, which will last him a month. The drugs are: Rapid Diagnostic Test (RDT), Arthesunate Amodiaquine, Paracetamol and a thermometer to measure the fever. To treat pneumonia they have Amoxicillin and a timer to contact respiratory movements. To treat diarrhea they have Oral Rehydration Therapy (ORS) and Zinc and to measure malnutrition they have a balance to weight of children. The stock is closely monitored and replaced by the RCom supervisor at the integrated health centre during his monthly visits,” says Mrs. Boubacar Haoua is in charge of integrated health centre five years.
"Since Aminou Moumouni started his work, we never received a cases of malaria, pneumonia and diarrhea in children (with ages between 2 to 59 months) from Kourfan Tsaouna village."
Aminou’s mother Rahamou Nadiguido (47 years old) recalls the pain of losing two children because she didn’t had the means to treat then. "Aminou’s older and younger brother died at a very young age simply because I couldn't effort to treat them. This was very common, I know a lot of women that loss children in this village for the same cause. My son’s job is honorable and effective, I’m really proud of him,” says Rahamou after inviting me to eat they local porridge made out of local millet.
Today World Vision can demonstrate through health district data that NICe-RAcE project has contributed for the reduction of morbidity and mortality among children aged between 2 to 59 months in three health districts of Dosso region (Boboye, Dogodoutchi and Dosso). The iCCM service can be consider a luxury one, even in the development countries and people like Aminou are around for a short period of time, that’s why RCom should be integrated in the national health structure to continue to provide the most needed health service to the vulnerable children and families in the rural communities of Niger.