For thousands of years, issues of illness and health were managed within local communities by midwives, traditional medicine men and others trusted community members. With the advent of modern medicine, however, treatment and care gradually shifted from self-taught amateurs in the home to nurses and doctors in bustling hospitals. While this model is now the norm in the developed world, it can be problematic in the developing world, where there are often not enough doctors, nurses and facilities to meet the needs of local populations.
In the case of combating malnutrition, the old – and often ineffective – approach was to lean heavily on these over-taxed hospital systems. After a child has become so badly malnourished over time that she must get immediate medical treatment, it can takes weeks of intensive therapy in hospitals already overflowing with other patients. Not only was this system costly for both hospitals and families, but it also proved to be a highly inefficient model for combating a preventable disease.
With this problem in mind, development agencies, NGOs and governments have in recent decades started relying on community health workers (CHWs) to bridge the gap in treatment and care. Much like their traditional forebears, CHWs are members of and chosen by their communities – a crucial factor in their effectiveness.
A key pioneer in this approach is Partners in Health (PIH), our partner in Malawi. PIH’s model implements CHWs as an interface between the community and medical personnel. CHWs can be family, friends or anyone in that local community who has been trained, PIH believes in some form of compensation, and their duties might include providing health education, referring people who are ill to a clinic, or delivering medicines and social support to patients in their homes.
The CHWs who work with PIH and Valid Nutrition, another 2 Degrees partner, are crucial in the distribution of the nutrition packs and the implementation of Community Therapeutic Care (CTC). This approach treats the majority of the severely acutely malnourished at home and focuses on outreach and community mobilization to promote participation and behavioral change. Practically, this means that our CHWs are instrumental in weighing the children, determining how many packs each child needs and monitoring progress – all without lengthy and expensive doctor visits.
To see the CHWs and families which your purchase of 2 Degrees bars helps, check out the gallery from our trip to Malawi and the Under 5 Neno clinic.