ArticleGlobal health, science and practice2021
Community Health Worker Program Sustainability in Africa: Evidence From Costing, Financing, and Geospatial Analyses in Mali.
Article in Global health, science and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Contextual Factors to Improve Implementation of Malaria Chemoprevention in Children: A Systematic Review.The American journal of tropical medicine and hygiene · 2024Pooled it
- Community-based interventions for non-communicable diseases in Africa: a scoping review of scope, effectiveness, and implementation factors.BMC public health · 2026Article
- Outcomes of community-based nutrition support groups in Dioila Health District, Mali.Frontiers in nutrition · 2026Article
- Understanding vaccine recommendation behaviours among healthcare workers in Senegal: A cross-sectional analysis.Tropical medicine & international health : TM & IH · 2025Article
- Do cash or digital payment modalities affect community health worker performance? - a case study of a remote refugee settlement in Western Uganda.Global health action · 2024Article
- Calculating the Costs of Implementing Integrated Packages of Community Health Services: Methods, Experiences, and Results From 6 sub-Saharan African Countries.Global health, science and practice · 2023Article
- Does mHealth influence community health worker performance in vulnerable populations? A mixed methods study in a multinational refugee settlement in Uganda.PLOS global public health · 2023Article
- Scaling severe acute malnutrition treatment with community health workers: a geospatial coverage analysis in rural Mali.Human resources for health · 2022Article
- Improving the efficiency of scale-up and deployment of community health workers in Mali: A geospatial analysis.PLOS global public health · 2022Article
- Community health workers at the dawn of a new era: 11. CHWs leading the way to "Health for All".Health research policy and systems · 2021Review
- Strength in Diversity: Integrating Community in Primary Health Care to Advance Universal Health Coverage.Global health, science and practice · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Mali, community health workers (CHWs) deliver essential community care (ECC) to rural populations. The dominance of external funding for the program threatens the sustainability of this critical workforce as donor financing decreases. This article summarizes results of analyses aimed at assisting Mali's decision makers and leaders in initiating a transition to a sustainable CHW program supported by domestic funding through strategic and rational investment.
methodsData on ECC implementation norms, workforce, coverage, utilization, cost, and geospatial features were collected between 2016 and 2019. The data informed interlinked CHW financing analyses-situational, services costing, efficiency, and geospatial mapping. Analysis showed distribution of reported expenditures, estimates of required CHW funding, cost-saving options, and spatially visualized discrepancies between spending estimates and normative costs.
resultsThirteen financing sources contributed to CHW program expenditures, 88% of which were from international donors, for a package of 23 curative, preventive, and promotive interventions. In 2015, the CHW program spent US$13.01 million; an estimated US$8.36 million would have been needed to achieve the same service volume under standard care protocols. Medicines and start-up training had US$6.88 million more than needed; supervision, program management, and recurrent training components were underfunded by US$2.2 million. Cost-saving opportunities of US$6.16 million were identified in 41 of 44 districts. Funding reallocation opportunities (after meeting technical efficiency requirements) were identified in 20 of 44 districts (US$2.56 million). Use of geospatial targeting and mapping suggests district- and village-level reallocation options for theoretical funding surpluses.
conclusionCHW costs can be significantly reduced without sacrificing service technical quality. Spending can be geographically targeted to optimize service use by rural populations. Efficiency analyses provide evidence to build stronger engagement, support improved decision making, efficiently prioritize resources, and target investments for sustainable financing of CHW programs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.