Community-Based Access

In many resource-poor environments, most sick persons (especially children) in rural areas are seen by community health workers (CHW) because public health services are not readily accessible. Various Ministries of Health wish to manage conditions such as malaria and pneumonia at the community level. The CGHD has been working to assess the effectiveness and feasibility of having CHWs diagnose and treat malaria with the aid of rapid diagnostic tests and manage pneumonia with amoxicillin. The CGHD is also looking at implementing a program of deploying rectal artesunate in children in a rural malaria-endemic locality in sub-Saharan Africa. The CGHD has found that pre-referral treatment with rectal artesunate is a cost-effective adjunct to standard parenteral treatment of severe malaria cases, judged by a standard of under US $50 per DALY (disability-adjusted life year) averted.