Generating More Health in Households: Health Made In Households (HEMIH)

Health Made in Households (HMIH) is truly effective in transforming lives in households in San district. Program income from the distribution of Health Boxes and reinforced by donor funding ensures continuity of project activities. Moreover, a loan of $25,000 guarantees the execution of the project. HMIH builds partnerships and support from community associations and international organizations. With HMH, there is a funding plan to support a scale-up of the project in the district. However, barriers that might hinder success of the project are identified and plans to overcome are developed. Financial insecurity can limit access to equipment and supplies and the implementation of activities. Weak community support can to weak or no ownership of the project. Nurturing partnerships with communities and listening to them ensures stronger project ownership. Without the community, there is no feedback and hence no strong reasons to revise strategies to make sure objectives and targets are being met. Limited geographical coverage reduces the client-base for health services. Long-term plans must guide geographical coverage with services. Free services or no cost-recovery does not guarantee any long-term financial security. When there is no accountability, partnerships fizzle out. Timely trouble-shooting the project for transparency and making corrective plans helps. Restrictive cultural norms impede making more health. Policy and high regulatory environment limit access to health services and so policy-friendly environments are important for making more health.

The lack of trained health providers in health centers and communities limits knowledge about HEHPs. It blocks access to health and requires training to transform health providers, health committee members and community leaders into people set for making more health. High Illiteracy bars informed adoption of health practices. With top-of-the art and largely pictorial manuals that meet the needs of illiterate people, makes education on HEHPs crucial. Materials that capture the interest of illiterate people are handy in making more health. Restrictive cultural norms hinder the making more health. Access to and use of high health services, especially by women, is often barred. Engaging men in activities and clarifying the roles of men and women are important to reducing the barrier.

Core HEMIH Partners include the 220 women's community associations. Apart from implementing HEMIH activities in all 25 local government areas in San, they serve as health platforms and outlets for health services and products. COFEMali San has funding partners, such as USAID and UNICEF who fund the training of association leaders; production of Community Health monitoring tools, production of communication tools (HEHPs) and client referral slips. There is a local NGo that provides training on HEHPs and produce communication materials, develop community distribution of health products, including: contraceptives, water purification tablets (Aquatabs).
COFEMali San/HEMIH project has developed partnerships with for Profit Companies, such as, Hotels, and transport companies. For-profit companies that sell health products for Association Health Box are partners who offer some rebates. Hotels offer rebates to project staff and technical assistance partners. Two Community radio stations are partners who provide reduced rates or free airtime for public service announcements. Two international NGOs -- World Vision and "Sante Sud" carry out the training of women in community development, including environment, water and sanitation.

Friends and family provide social support to members who adopt HEHPs. Individually, they adopt and promote HEHPs adoption among peers. National NGOs train leaders of associations of men, women, youth, churches, schools, etc. as CRWs who promote HEHPs. International NGOs/Non-Profits provide technical assistance. The Academia/Universities include Georgetown University/Institute of Reproductive Health), Johns Hopkins University/JHU/CCP, University of North Carolina/INTRAH. Donors include USAID through its community health called Keneya Ciwara and UNICEF, through its district health program. Businesses resupply health commodities to the associations in the HMIH. District/Regional government and Communal offices facilitate the development and registration of the women’s associations. Communal officers are communication links between COFEMali/ Bamako and associations in remote areas. Some government members participate in monitoring household action plans after adopting a HEHP. The National government creates a friendly political environment for HMIH operations and provides service technical and policy guidelines. It supports through in-kind contribution including salaries paid to district health team for time spent with members of women’s association who attend monthly meetings on HMH or training sessions on HEHPs, lodging, transport to meetings. Clients including household members generate demand for health and contribute financially to procure health services and supplies through membership fees. Some clients transport health commodities to associations in remote areas.