PEDAL POWER: Community health workers in Cote d’Ivoire get on their bikes to tackle malaria in remote villages

YAMOUSSOUKRO, Cote d’Ivoire, 25 April 2024 – Equipped with bikes and medical kits, thousands of community health workers in Cote d’Ivoire are tackling malaria by cycling between remote villages to treat children and educate families, reducing cases by up to 70% in some areas so far this year.  

With progress in reducing malaria grinding to a standstill globally in recent years, the World Health Organization is using World Malaria Day 2024 on April 25 to try to again accelerate the fight against the mosquito-borne disease that kills about half a million children every year.  

According to the WHO, 94% of malaria cases and 95% (580,000) of malaria deaths occur in Sub-Saharan Africa, with children under five most severely impacted, accounting for about 80% of malaria deaths in the region. 

Malaria is endemic in Cote d’Ivoire which is listed among the top 10 countries with the most cases of the disease. In 2022 the West African nation which has a population of about 28 million accounted for 3% of all malaria cases globally, according to the WHO malaria report.  

In a bid to tackle the disease, a team of about 8,300 community health workers equipped with bikes have become key players in reducing malaria mortality among children under five by diagnosing and treating the disease earlier. Early diagnosis also means that children needing more comprehensive care can be referred to public health centres early enough.  

Community health workers like François Kouadio, 46, a father of six himself, are being supported by Save the Children and a group of local partners to make sure families impacted by malaria are reached in a timely way.  

 He trained as a community health worker in 2015 and runs blood tests on children to test for malaria and, if positive, treats them with paracetamol and malaria tablets. He also provides care for pregnant women in the village to make sure their risk of getting malaria is minimal.  

 One family he helped this year was that of Prisca*, 28, who noticed changes in her third and youngest child Charlene*. Her one-year-old daughter lost her appetite, lacked the energy to play, and spent most of her time sleeping. One night, Charlene* was struggling to breathe properly and was shivering with a high fever.

 Having a community health worker living in the same village allowed Prisca* to seek help from François quickly. The early diagnosis and treatment, accompanied by François’ daily visit to the family, mean one-year-old Charlene* was saved from malaria and can enjoy playing with her brothers again.  

 François has been able to scale up his work in recent years due to having a bike, visiting up to eight families a day within a five-kilometre radius. He pedals along dirt roads to rural villages where brick houses stand among green forests. He checks if any children are sick, provides appropriate treatment, while raising awareness about malaria and how to prevent it.

 François’s hard work and dedication has won him respect within the community, where people even call him ‘doctor’. Every ding from bells on bikes used by François and three other community health workers brings comfort to the people in the villages knowing that healthcare is accessible.  

 “I was so scared my daughter might die when she was sick,” Prisca said. “(But) my family could see that the medication was working, and we have confident in the treatment. The community health workers are very kind, they give us the tablets for free, and the children recover from their sickness. They do such a great job at bringing comfort to the people in the village.” 

 Francois said from January to March this year, he tested 31 children with fevers, of whom 24 tested positive for malaria and received treatment. This was a massive drop from previous years. 

 "In the past, between 20 and 30 children were registered with malaria in a month alone, but with more awareness on malaria, almost everyone now sleeps under a mosquito net and malaria cases have dropped significantly,” he said. 

 François said people shy away from visiting health centres due to a lack of money, but he is dedicated to caring for children and raising awareness about how to prevent malaria after seeing too many deaths from the disease. He not only encourages people to get appropriate treatment but to also protect themselves by using mosquito nets, keeping houses clean, and covering up water storage containers. 

 Local radio stations are also part of Cote d’Ivoire’s drive to combat malaria, broadcasting messages about how to treat and prevent the disease. Overall, the aim in Cote d’Ivoire is to reduce malaria incidence and mortality by at least 75% by 2025 compared to 2015. 

 Malaria is an illness spread by female mosquitoes infected with parasites. If untreated, it can be deadly. In 2022, there were an estimated 249 million cases of malaria worldwide, with children younger than five being the most vulnerable.  The infection can also lead to substantial risks during pregnancy.

 Dr Yssouf Ouattara, Save the Children’s Malaria Project Director in Cote D’Ivoire, said:   “Malaria is preventable and curable, but without access to care it can become deadly – especially for young children. Innovative community health projects like the one run by Save the Children in Cote D’Ivoire are important because the community health workers are able to see and treat children at home and in communities, leading to hugely improved results.” 

 Save the Children has been working in Cote D’Ivoire since 1991, working across education, health and nutrition, child protection and child rights, and to fight against child poverty. The malaria project is implemented in about 53 health districts in the country and in more than 1,270 health areas, in collaboration with six other organisations.

 EDITORS NOTE: 

The six other organisations involved are: 

- ROLPCI (Réseau des Organisations de Lutte contre le Paludisme en Côte d’Ivoire) _Network of Organisations Fighting Malaria in Côte d'Ivoire 

-  APROSAM (Association pour la Promotion de la Santé de la Femme, de la Mère et de la famille) _Association for the Promotion of Women's, Mother's and Family Health 

- AIP (Association Ivoirienne pour le Progrès) _ Ivorian Association for Progress 

- ARSIP (Alliance des religieux pour la Santé Intégrale et la promotion de la personne Humaine)_ Alliance of Religious for Integral Health and the Promotion of the Human Person 

- IRC (International Rescue Committee) - ASAPSU (Association de Soutien à l’Autopromotion Sanitaire Urbaine) _  Association supporting