A tale of three villages

A new approach bringing together malaria and pneumonia treatment by community volunteers that could reduce childhood deaths in Africa

The Sidéradougou Health Centre: limited resources for 39 000 people

The facility that Sawadogo took his daughter to is the Sidéradougou Health Centre, headed by nurse Nébila Bationo. This was the only health service available to 39 000 inhabitants of the surrounding villages before the advent of the community management system.

The centre itself has limited resources – just ten hospital beds, five of which are in the maternity ward, and a staff of ten health workers, four of them nurses. Bationo guides his visitors past a crowd of people lined up in front of the drug dispensary with mid-day temperatures rising to 40 degree Celsius. Outside his office, an ambulance, in need of repair and out-of-use for six months, is parked.

Bationo praises the community case management programme, noting that he has seen a dramatic reduction in the number of patients who come to the Sidéradougou centre from the participating villages. He proudly raises a trophy he received for being "the best nurse working on the programme in 2010." His prize, along with others awarded to the top community health workers as incentives, was presented by the provincial High Commissioner at a high-profile ceremony covered by the national press.

"But at the beginning, the research initiative also created a difficult personal situation for me," Bationo points out, describing how people in the control group villages confronted him with requests to be included. Bationo was able to gain their understanding by explaining to them that they would also join the programme at a later stage. The study is implemented in steps with all villages being gradually covered over time. In this way, some villages serve as a control group until they get the intervention.