Mali

The Problem

  • The under-five mortality rate in Mali is the sixth highest in the world; 2005 figures revealed that 218 children out of 1,000 die before they see their fifth birthday.
  • Mali is endemic with five major Neglected Tropical Diseases, including blinding onchocerciasis and trachoma, Lymphatic Filariasis, Soil-transmitted helminths (STHs), and schistosomiasis. The majority of the population is at risk for co-infection with at least two Neglected Tropical Diseases. These diseases reduce productivity and cripple the country’s potential for social development and economic growth.  

What HKI Is Doing

Helen Keller International has operated in Mali since March 1998 and provides technical assistance to government and non-governmental partners at the national level. Current programs include:

Neglected Tropical Disease Control
Since 1996, Helen Keller International has been a partner with the Government of Mali to control onchocerciasis and trachoma; recently our programs in the country have expanded to include the control of other Neglected Tropical Diseases, including the elimination of lymphatic filariasis (LF) and treatment of soil-transmitted helminths (STHs). 

Trachoma Control
In close collaboration with The Carter Center, Helen Keller International implements the WHO-endorsed SAFE strategy (Surgery, Antibiotics, Face-washing, Environmental change) to eliminate trachoma as a cause of blindness by the year 2015. HKI works to implement trachoma control programs in five priority regions (Kayes, Koulikoro, Mopti, Ségou and Sikasso) where the disease is highly endemic.

In 2009, HKI supported the delivery of 787 trichiasis surgeries and provided 30 outreach surgical missions. HKI is also working with the community radio stations to broadcast public health messages about trachoma. From mid-May through August 2009, 36,000 radio broadcasts in five languages (French, Bamanan, Peul, Soninke and Senufo) were aired to raise awareness of trachoma.

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Vitamin A Supplementation
Helen Keller International has been a catalyst in developing mechanisms to ensure twice-yearly distribution of vitamin A for children 6-59 months, and the program in Mali is a mature one. Last year, vitamin A supplementation achieved 90% coverage, reaching almost 2 million children. The program also incorporates de-worming services for children 12-59 months.

Food Fortification
HKI works with the National Program for Food Fortification to advance our Tache D’Huile initiative, a partnership between public and private party stakeholders focused on fortifying cooking oil with vitamin A.

Orange-Fleshed Sweetpotato
Surveys using a food frequency methodology developed by HKI revealed considerable increases in orange-fleshed sweetpotato (OFSP) consumption by children. In a province in Mali, OFSP were consumed at least once a week during the harvest period by over 85-91% of adult women and by 18-30% of children, depending on the site.

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Community Management of Acute Malnutrition
Malnutrition is an acute public health and development problem in countries in the Sahel region (on the southern border of the Sahara desert), like Mali. Helen Keller International and our partners, working in the Koulikoro region, have developed and institutionalized an intervention model that both treats and prevents malnutrition. The Community-based Management of Acute Malnutrition (CMAM) model provides a holistic approach by building the capacity of community structures already in place, training community members, and minimizing the time mothers and children must be away at emergency feeding centers and away from the home.

Since the beginning of the program in Mali in 2006, CMAM has been established in 34 community health centers and two district health centers, and a hospital has been renovated and equipped so that it can serve as a stabilization center for severely acute malnourished children.

Last year, HKI trained 729 community health workers and community volunteers to identify and refer malnourished children for treatment, follow the children and their families through treatment, and provide counseling to families on improved nutrition-related practices. HKI promotes the Essential Nutrition Actions (ENA) to teach mothers and caregivers practical activities for infant and young child care. In the past year, almost 19,000 pregnant or lactating mothers received counseling on infant and young child feeding. In addition, 651,320 people received information on the ENA through radios broadcasts, group discussions, and direct, personal communications. HKI’s work in the Koulikoro Region of southwestern Mali was highlighted as a success story on USAID’s website.

Only acutely severe malnourished children with complications are kept in the centers; children with appetites receive ambulatory care and caretakers are provided with Ready-to-Use-Therapeutic Foods (RUTF), such as Plumpy’nut, as well as medication and instructions for the treatment at home.  In one year, over 11,000 children were treated with supplementary feeding (those with moderate, acute malnutrition) while almost 1,500 were treated with therapeutic feeding (those with severe, acute malnutrition). In addition, 423,289 were provided with vitamin A Supplements.

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