Combine local resources and mobile technologies to increase child & mother resort to care in Mali.
Mali faces dreadful levels of child & maternal mortality, mostly due to benign pathologies that could however easily be cured locally. Due to cultural, financial and geographical reasons, people resort rarely - and too late - to healthcare. As a result, untreated diseases get complicated and become lethal, while under-used health structures encounter economic difficulties.
Pesinet deploys an innovative home-based monitoring health service, using technologies, that promotes prevention & facilitates early access to basic medical care. Its objectives are to accelerate resort to care and avoid complications of diseases; to improve sensitization to essential health & hygiene practices; and to help primary health centres reconnect with populations and increase their level of frequentation.
A propos de vous
A propos de vous
A propos de votre organisation
Nom
Association Pesinet
Site Web
Téléphone
+336650967512/+33668061775
Adresse
6 avenue des Pavillons, 92270 BOIS COLOMBES
Pays
France
Pays dans lesquels ce projet crée un impact social
Mali, CD
Votre organisation est-elle une
organisation à but non lucratif
Depuis combien de temps votre organisation opère-t-elle ?
1‐5 années
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Innovation
Titre du formulaire de participation
Combine local resources and mobile technologies to increase child & mother resort to care in Mali.
Quels changements pensez-vous apporter ?
Mali faces dreadful levels of child & maternal mortality, mostly due to benign pathologies that could however easily be cured locally. Due to cultural, financial and geographical reasons, people resort rarely - and too late - to healthcare. As a result, untreated diseases get complicated and become lethal, while under-used health structures encounter economic difficulties.
Pesinet deploys an innovative home-based monitoring health service, using technologies, that promotes prevention & facilitates early access to basic medical care. Its objectives are to accelerate resort to care and avoid complications of diseases; to improve sensitization to essential health & hygiene practices; and to help primary health centres reconnect with populations and increase their level of frequentation.
Quelles sont les principales activités mises en place par le projet ?
In partnership with local primary health structures (CSComs), Pesinet implements a service for children under 5 that combines health follow-up, insurance cover & education to prevention and good health practices.
It is based on the work of agents in the communities and on technologies. Through frequent monitoring of simple indicators, it enables early-detection and treatment of benign pathologies. It works as follows:
•Every week, Pesinet’s agents visit the children at home and collect simple health data (weight, fever, stools…). They also provide nutrition and prevention advice.
•Data is transferred to the doctor of the partnering CSCom via mobile and internet technologies. He reviews the data and identifies children at risk.
•When children are called in by the doctor, Pesinet covers medical costs (100% examination + 50% medication).
•Families subscribe voluntarily. The monthly price for the whole package is 500 FCFA (€0,75) per child.
We plan to develop a similar service for pregnant women.
Activities are organized in small operational units. In each district, Pesinet works with the referring CSCom, in line with the Malian administrative health zoning.
Pesinet’s goal is to generate a cultural change in the health behaviors of populations, and trigger a virtuous cycle for the whole healthcare system of Mali. By detecting diseases and prompting people to treat them early in CSComs, we enable that they remain benign, and that the different levels of health structures are used appropriately.
Our service is currently deployed on 1 site in Bamako, in the area of Bamako Coura.
En quoi votre initiative est-elle innovante ? Dans quelle mesure apporte-elle une contribution originale dans son domaine ?
Our approach is innovative because:
1.We have a demand-driven approach to improving health services. In the last decades, most health development projects have aimed at bringing additional medical resources. We reckon this is inefficient if those resources are not used by the population. Increasing resort to care is the key to generate a systemic and lasting change.
2.With one simple solution, we address the financial, geographical and cultural barriers altogether. Mutual insurance systems encounter difficulties to develop as they fail to raise awareness on the value of prevention. Through our network of health agents, we reach populations and introduce health directly into the households.
3.Anchored in the local Malian ecosystem, our service strengthens the public healthcare system instead of replacing it. We reinforce the role of community health structures as the key lever for primary health.
4.We use simple technologies to increase medical radius, accelerate detection and families’ warning, and support management of activities. The IT system we have developed enables remote follow-up of children, keeping of medical records, and production of reports and health statistics.
5.We adopt a paying approach, in order 1) to build a sustainable financial model, 2) to be aligned with the Malian health financing policy based on the principle of cost recovery, and 3) to give families a sense of responsibility through a voluntary decision to enroll their children.
A quel étape votre projet en est-il ?
En place depuis 1 à 5 ans
Comment décririez-vous la population auprès de laquelle vous travaillez ? Parlez-nous, par exemple, de la situation économique, des structures politiques, des normes et des valeurs, de l'évolution démographique, de l'histoire ou des précédentes expériences d'engagement communautaire.
We currently work with Malian families living in urban areas. Our service is targeting low income populations, mostly living from the informal economy, which constitute the great majority of people in Mali.
Families are large in size: polygamy is frequent and there is no family planning (women have 7 children on average, with pregnancies close together).
Resort to care is weak and populations distrust conventional medicine. They tend to favor family advice, self-medication or traditional medicine. Popular beliefs are strongly anchored and, as the level of education is low (70% of mothers have either no education or just an elementary one), families often do not recognize the symptoms & diseases, or choose inadequate treatments.
In urban setting, the father is responsible for providing food and money to the family, while the mother takes care of the children. As a consequence, mothers are generally the ones to decide to enroll their child into the Pesinet program and then convince their husband to pay for it. The father has limited information about his child health because he is away during the day. The population we target has very little understanding of the benefits of prevention.
To reach this population, we favor working with national staff members. The network of agents that we hire in partnership with the healthcare centers are from the district covered. They are trusted and well-known women in the community. This allows them to work closely with mothers and children, convince them of the added-value of prevention and create a reassuring climate for families.
Racontez l'histoire du fondateur et ce qui l'a inspiré à démarrer ce projet
Pesinet was founded by Pierre Carpentier, Antoine de Clerck and Anne Roos-Weil in 2007. The NGO is currently managed by Anne Roos-Weil.
The history of Pesinet dates back to the early 2000s. The founding concept - detecting simple children diseases through tracking of their weight - was initially developed by a French philanthropic venture capital firm, Afrique Initiatives. A pilot experiment was launched in Senegal, which had to stop by lack of a sustainable economic model.
In 2006, Antoine de Clerck and Pierre Carpentier, former members of Afrique Initiatives project team, enrolled the idea into an academic program held by top French business school ESSEC and engineering school Ecole Centrale. A team of students worked 6 months on a business plan and designed the service as it is now, including use of technologies, self-sustaining economic model, health insurance model. The team was led by ESSEC student Anne Roos-Weil.
Already graduate in Political Sciences, Anne was passionate about development issues. Coming from a family of doctors, she was particularly interested in public health. At the end of the 6 months, Pierre, Anne and Antoine decided to launch a pilot experimentation in Mali, and founded the NGO.
In 2009, after obtaining a grant from the social incubator Antropia, Anne decided to engage full-time in the project and give it the means to reach its full potential. She has been CEO of Pesinet since then. In 2010, the quality of her approach was further acknowledged, as she became Ashoka Fellow. She is currently based in Mali.
Impact social
This Entry is about (Issues)
Décrivez les résultats positifs obtenus par votre projet ainsi que la façon dont ils sont mesurés.
The project is showing very encouraging results.
An impact assessment study was carried out from September 2010 to July 2011 under the supervision of an independent expert, in order to validate the sanitary and socio-economic impacts of our service.
First results demonstrate the positive impact of Pesinet for families and for healthcare structures:
– High level of satisfaction for the service: 94% of global satisfaction rate among subscribing families
– Affordability for low-income populations: 97 % of families deem the service « very affordable », even though 90% have unstable revenues
– Efficient detection system: 93 % of consultations post–summoning have confirmed that the child is sick
– Increase in resort to healthcare: 1 out of 4 subscribing children are seen at least once a month by the doctor (when the average Malian resorts to health facilities only 0,41 times a year)
– Increase in health centre activity: 37% of new consultations of children from the program area can be attributed to Pesinet ; 70% of medication prescribed to Pesinet subscribers is bought directly at the pharmacy of the health center
Though it is too early to provide reliable health statistics at this point, there have been 2 deaths on the 1000 children followed-up by Pesinet, for a national child mortality rate of 191‰.
The first evaluation has demonstrated the effectiveness of the program in improving use of primary healthcare facilities. It is now necessary to provide evidence that this effectively reduces the risk of complication and the need for costly emergency treatments (see Sustainability).
Combien de personnes ont été touchées par votre projet ?
Entre 1 001 et 10 000
Combien de personnes pourraient être touchées par votre projet au cours des trois prochaines années ?
1,001-10,000
Les projets gagnants possèdent un programme solide indiquant leurs prévisions de croissance. Identifiez l’objectif à atteindre au bout de six mois pour accroître vos résultats.
We plan to have 1120 children enrolled in Pesinet, in our 3 operational sites in the Commune 3 of Bamako (Bamako Coura, Dravela and Ouolofobougou).
Tâche 1:
Finalize negotiations on operational launch schedule with the Community Health Centers of Dravela and Ouolofobougou.
Tâche 2:
Get equipment and install it in the partnering centers (computers, mobile phones, baby-scales, height gauges), hire and train staff (agents and personnel of the healthcare center).
Tâche 3:
Promote the service among the populations and enroll children through active communication and social mobilization campaigns.
Identifiez l’objectif à atteindre au bout de 12 mois.
We plan to follow 1440 children in Bamako Coura, Dravela and Ouolofobougou, as well as 330 women in our pregnancy care pilot site.
Tâche 1:
Design sanitary, operational and economic features of the pregnancy care service (selection of relevant health indicators, periodicity of visits, price of service).
Tâche 2:
Negotiate partnership conditions with potential partners (Community Health Centre of Banconi and partner NGO - the pilot will be launched in partnership with an international NGO).
Tâche 3:
Actively promote the service on the new site and pursue communication efforts in the three sites of Commune 3.
Quelle va être l'évolution de votre projet lors des trois prochaines années ?
3 main projects are planned:
-Extension in Bamako: On top of our Bamako Coura site, we plan to open 2 new sites in adjacent areas, Dravela and Ouolofobougou in fall 2011. We have finalized negotiations with the CSComs and are preparing the launch.
-Development of a pregnancy care service: We will first experiment it alone, before combining it with the children service. A pilot is planned for mid-2012 in the area of Banconi (Bamako.
-Test in rural zone: this is key for large scale extension –73% of people live in rural areas– and will require refining of the service to adapt to rural constraints. We plan to launch a pilot in fall 2012, children and pregnancy care combined.
Once the pregnancy care service & the rural processes are ready, we will be able to develop at a large scale.
Viabilité
Quels sont les obstacles qui pourraient entraver la réussite de votre projet et comment comptez-vous les surmonter ?
Relationships with CSComs: We are dependent on the will of CSComs to implement the Pesinet service and work with us. This might be challenging has those structures are run by community-based committees elected for 3 years. Newly elected committees can have a limited understanding of the benefits of Pesinet. To overcome this challenge, we work with the National Federation of Community Health Associations to facilitate buy-in and sustainability of the service in the affiliated Health Centers.
Quality of health services in the CSComs: The quality of Pesinet service is dependent on the quality of health supplied by the partnering CSCom. In many, service quality is poor, notably when it comes to welcoming patients, as staff is under-paid and not properly trained. We expect to help Centres improve their revenues and thus their performance in the long run. In the meantime, we complement our demand-driven approach by reinforcing CSCom capacity through training. We also consider partnerships with organizations focused on reinforcing healthcare supply capacities, so as to multiply the impact on both the demand and the supply side.
Economic model: Our first aim was to achieve 100% local operational self-financing, i.e fees paid by families covering the running costs of the service. Experience shows that, at current price and current level of service, we are able to achieve 50%, while the other 50% are covered by external sources (for the moment, funds raised by the NGO). We have yet to find a sustainable economic model. Several potential solutions are under study (see below).
Quels sont vos différents partenariats ?
Pesinet develops its projects through a double partnership with the Malian health authorities:
o Strategic partnership with the Ministry of Health. The objective of the partnership is to ensure that the Pesinet project contributes to the country’s health policies & strategy. And the Ministry commits to support the large scale development of PESINET’s activities in Mali and to contribute to the evaluation of the project.
o Operational partnerships with the Community Health Centres (CSComs). The perimeter of these partnerships is the area covered by the center. Both parties agree on their respective roles, responsibilities and obligations in the implementation and day-to-day operation of the service. We have an agreement with the Centre of Bamako Coura, and are finalizing agreements with the CSComs of Dravela & Ouolofobougou.
We also have partnerships with several companies and private foundations that bring us financial, material or skills support, on a one-shot or recurrent basis.
Actuellement, quel est votre budget annuel (USD) ?
$50,001‐100,000
Expliquez vos choix.
Families & friends: Pesinet is still a young project, where the personal implication of the members and of their entourage is very important. Our families and friends bring their affection and their financial support as many of them make donations to the NGO. Many also put their skills to good use and easily volunteer to help us.
Individuals: Our approach is acknowledged and supported by several experts in the field of health and/or development. They enrich the project with their knowledge and advice. Some have joined our board of directors or our advising board.
Companies & corporate foundations: So far, most of our funds have come from companies or corporate foundations. This has enabled to preserve the flexibility we needed as a young and small NGO at the stage of experimentation. As we grow, we will start diversifying our financial sources, notably towards national and international public institutions.
NGOs: More and more NGOs are hearing from us and showing their interest for what we do. Several have contacted us, expressed their enthusiasm for the project, suggested common projects or even required our assistance or expertise. For instance, Action Against Hunger in Mali has recently asked for our technical assistance for a nutrition project in which they plan on using technology for health data reporting.
Government: As explained above, the Malian Ministry of Health supports our actions.
Comment pensez-vous pouvoir consolider votre projet au cours des trois prochaines années ?
• Further strengthen relationships with Malian public health authorities: We have associated the Ministry of Health and the FENASCOM (National Federation of Community Health Centers) to the negotiations for the first extension, so as to validate a standard partnership agreement that will facilitate further replication. As a result, we have just signed a partnership agreement with the FENASCOM to cooperate on the development and roll-out of the Pesinet service in Mali.
• Validate a viable economic model: Our aim is to validate a sustainable economic model, based on self-financing maximization complemented by sustainable external sources. Favored ideas currently under study are cross-subsidization, contribution from public national or local authorities, and partnerships with mutual and insurance companies.
• Evaluation: We need to conduct a more thorough evaluation so as to measure impacts on: 1. the reduction in emergency health treatments and the associated savings for private and public organizations involved in healthcare, 2. epidemiological impacts, to demonstrate the effectiveness of the approach in the long run. To do so, Pesinet is looking for financial and technical partners to undergo a 3-year monitoring of the use of healthcare structures and the health spending of two cohorts of people (subscribers and non-subscribers) in order to monetize the benefits of the Pesinet service as well as to define relevant indicators to appreciate the level of gravity in the health status of people resorting to health facilities.
Enjeux
Quels problèmes liés à la santé et au bien-être votre projet tente-t-il de résoudre ?
Veuillez sélectionner trois réponses par ordre d'importance (notées de 1 à 3 par ordre de pertinence).
PRIMAIRE
Changement du comportement sanitaire
SECONDAIRE
Manque d'assurance / d'options de financement des soins de santé
TERTIAIRE
Accès limité aux outils ou aux ressources préventives
Veuillez décrire la façon dont votre projet s'attaque spécifiquement aux problèmes cités ci-dessus.
- Pesinet combines a system of early-detection and families’ warning with ongoing sensitization to prevention in order to generate a cultural change in the health behaviors of populations.
- In Mali healthcare is not free: populations have to pay for medical examination and medication. A social protection scheme is currently being developed, and will concern the highest and lowest layers of the social pyramid only. 80% remain uncovered. Our insurance cover scheme makes primary care affordable.
- CSComs lack resources to develop preventative services on top of curative services. Within the centres, we implement a service that enables them to reach populations and foster a culture of prevention and early resort to care, through a network of agents and through sensitization events.
De quelle façon faites-vous croître l'impact de votre organisation ou de votre projet ?
Veuillez sélectionner trois moyens potentiels par ordre d'importance (notés de 1 à 3 par ordre de pertinence).
PRIMAIRE
Renforcement de l'impact existant grâce à la mise en place de services complémentaires
SECONDAIRE
Croissance géographique: au sein du pays d'origine
TERTIAIRE
Influence sur d'autres organisations et institutions grâce à la diffusion de meilleures pratiques
Veuillez indiquer les activités actuellement en place ou devant être mises en place dans un futur proche pour stimuler votre croissance.
In the very short term, we will focus on improving the self-financing rate by exploring opportunities to develop a service targeting a wealthier segment and that could generate enough revenues to subsidize our core service, which we want to maintain as affordable as possible. We will carry out in the fall 2011 a thorough market study to design and price this “premium” package and assess its market potential.
At the same time, we will work on expanding the number of beneficiaries in the two new units in Bamako. Promotional activities are planned in the short term to develop adoption of the Pesinet service within the target areas, through local town criers, local radio, and traditional communicators. The objective is to cover 40% of under 5 children of the district in 18 months.
Êtes-vous en collaboration avec : (plusieurs réponses possibles)
Organisme gouvernemental , une entreprise à but lucratif.
Si oui, dans quelle mesure ces partenariats ont-ils contribué à la réussite de votre projet ?
Our partnership with the Malian Ministry of Health provides support for development of activities, and ensures that we are in line with the country’s health strategy.
Our partnerships with companies have given us the funds, equipment and sometimes competences necessary to develop and implement our activities.
We do not have a dedicated partnership with a university, though we have relationships with several academics. Our evaluation has been supervised by Marie-Pierre Gagnon, professor at Laval University in Canada and expert in evaluation of e-health projects. We also work with Phd students from the INSERM Research Institute in France and the London School of Hygiene and Tropical diseases.
| Fichier attaché | Taille |
|---|---|
| mobile_application_used_by_agents.jpg | 80.04 Ko |
| web_interface_used_by_doctor.jpg | 61.55 Ko |
| examination_of_a_pesinet_child_by_local_doctor.jpg | 208.85 Ko |
| mothers_discussing_health_issues_at_a_sensitization_event.jpg | 790.84 Ko |
| pesinet_agent_weighing_a_child_during_a_home_visit.jpg | 844.8 Ko |
 | 26 weeks agoAnne Roos-Weil said: Bonjour Benoît, Désolée pour la réponse tardive et merci pour votre commentaire et votre intérêt pour le projet Pesinet. Je vais ... about this Competition Entry. - lire plus > |
| 28 weeks agoBruno de Benoist said: Pour avoir travaillé moi-même dans le domaine de la nutrition et de la santé publique en Afrique pendant plusieurs années, je reconnais ... about this Competition Entry. - lire plus > |
| 29 weeks agoLucie de Clerck said: And thanks for the positive energy YOU brought us during one month! about this Competition Entry. - lire plus > |
| 29 weeks agoPascale Couderc said: Hello, I am really impressed by the quality of Pesinet project which is a real innovative approach of health care in a sustainable ... about this Competition Entry. - lire plus > |
| 29 weeks agoLucie de Clerck said: Hello Vincent, thanks for your support and your question! Replication in other countries is in the DNA of Pesinet. The principle of ... about this Competition Entry. - lire plus > |
| 29 weeks agoAnne Roos-Weil said: Anne-marie, Thanks for your kind message. It is great to have supporters like you! about this Competition Entry. - lire plus > |
| 29 weeks agoAnne-Marie Reynaud said: Best of luck to the Pesinet team! This is a wonderful project, very much needed and into which a lot of work and devotion have been ... about this Competition Entry. - lire plus > |
| 29 weeks agovincent nicollet said: Hello, You'project looks really great... Have you already studied the opportunity and feasability of replicating your project in other ... about this Competition Entry. - lire plus > |
| 30 weeks agoAnne Roos-Weil said: Hi Caroline, Since our work is very much anchored in local territories where primary healthcare centers are operating, it is important ... about this Competition Entry. - lire plus > |
| 30 weeks agoAnne Roos-Weil said: Thanks Antoine for the continued support ! Fingers crossed... about this Competition Entry. - lire plus > |