Child Survival 20 - Mali: Scaling-up community-based services in the Sikasso region of Mali. Cooperative Agreement No.: GHA-A-00-00003-00 final evaluation report 30 September 2004 - 30 September 2009.

CS-20 “Scaling-up Community-based Services in the Sikasso Region of Mali” was designed as an expanded impact project to reinforce community-based management of childhood illnesses. The goal was to obtain a sustained reduction in under-five mortality in Sikasso with two specific objectives: 1) To increase the use of key health services and improved child health practices at the village level; and 2) To increase the capacity of local entities (RHOs DHOs and community organizations) to assume responsibility for health activities while adopting innovative CS-20 approaches. Below is a sample summary of the progress made towards most CS-20 objectives: CS-20 established 477 VDKs in 464 villages and trained over 928 (CHWs). 90% of these VDKs had no stock-out of ORS and none had FP methods stock-out from July to September 2009. Zinc was added to the national list of essential medicines for the management of diarrhea and was also introduced at the VDK level. Malaria: Increase from 25.8% to 82.8% the percentage of children under 5 who were treated at a VDK or Health Center. Increase in number of children < 5 (from 8.4% to 70.6%) and pregnant women (from 25.9% to 66.2%) sleeping under insecticide treated nets (ITNs) the previous night; 82.5% of the households surveyed had at least one bed net. Diarrhea: Increase in number of children < 5 with diarrhea in last two weeks treated with ORS home fluid and/or increased fluids from 17.5 % to 67.7%. FP: Increase in the number of women who use a modern method of FP (from 5.1% to 14%). ARI: Increase from 25% to 44.7% of children < 5 with rapid breathing who visited the VDK for treatment and were referred to the HC. Increase in the number of women who know where the VDK is located from 30.5% to 74.5%. Progress reflected by a slight increase in the number of mothers who know three or more child illness danger signs (60.7% to 62.7%). (Excerpts)