Center for Health Market Innovations (CHMI)

Programs

Pesinet

last updated Jul 31, 2012

Overview

Implementing organization: 
Association Pesinet
Implementation Partner(s): 
National Federation of Community Health Centers (FENASCOM), Ministry of Health
Legal Status: 
Private (not-for-profit)
Year Launched: 
2008
Stage: 
Existing/expansion stage
Income Level of Target Population: 
All income levels

Funding

Primary Source of Funding: 
Donor
Additional Source(s) of Funding: 
In-kind contributions, Membership/subscription fees, Out-of-pocket payments
Funders: 
Alcatel-Lucent Foundation, Ashoka, BNP Paribas Foundation, Medex, Orande Mali Foundation, Sanofi Espoir Foundation, Terre Plurielle Foundation

Technology

Technology Used: 
Phones › Apps/Software, Computer › Apps/Software, Phones › Internet, Computer › Internet, Remote Diagnostic Tool, Unique ID (biometric/barcode scanner, etc.)
Technology Purpose: 
Improving Data Management › Data Collection, Improving Data Management › Data Organization/Analysis, Improving Diagnosis and Treatment

Scale

Personnel Employed: 
10-49
Number of Clients Served: 
Since 2009, over 1400 children have been enrolled in PESINET by their parents; 900 children are actively being served.
Number of Facilities Operated/Networked: 
3
Upscaling: 
Pesinet first implemented the program in a specific district of Bamako, called Bamako Coura. After 24 months of running the service and based on the results of the independant evaluation, Pesinet extended the service into two new districts of the city.
Summary: 

Pesinet designs and deploys innovative proximity (technology-based) services targeting children and their mothers. These services include regular home-based health monitoring, health insurance, and education to prevention. Delivered in partnership with local health structures (CSComs), they leverage simple mobile technologies as well as the work of agents in the communities to enable remote monitoring by the local doctor, accelerate disease detection, and facilitate early access to basic medical care. They are designed to be economically sustainable while remaining affordable to low-income populations.

Program goals/rationale: 

Pesinet’s mission is to sustainably reduce child mortality by facilitating access to existing healthcare systems. Many Sub-Saharan countries face dreadful levels of child and maternal mortality. Yet most of these deaths could be avoided: children and pregnant women die mostly from benign illnesses that could easily be cured with the medical resources available locally. People resort too little and too late to the doctor when sick, for cultural, financial and geographical reasons. As a result, untreated diseases become complicated and lethal, while under-used local health structures encounter economic difficulties. In many countries suffering from high mortality rates, lack of demand for health is at least as big an issue as the quality of available health structures. By addressing the issue from the demand perspective and reconnecting people with healthcare structures, Pesinet aims at generating a systemic change in the healthcare situation of Sub-Saharan countries.

Pesinet working towards a double impact that will create the necessary conditions for sustainable change in the healthcare situation of the countries where it works:

  • Impact on populations: increased resort to care; reduced delay in resorting to healthcare when the child is sick; improved education on prevention and key health practices;

  • Impact on health systems: increased activity at primary level, increased revenues for community health centers; improved capacity to deliver quality services.

Key program components: 

Pesinet has developed a service for children under 5 that is currently deployed in Bamako, Mali. Working in the 3rd District of Bamako, Pesinet has enrolled 800 children in the service, which works as follows:

  • Every week, Pesinet’s agents visit the children at home and collect simple health data (weight, fever, stools, etc.). They also provide nutritional information and illness prevention advice.
  • The collected data is stored on a Java applet in the agents' mobile phones and transferred to the doctor of the partnering CSCom via mobile technologies.
  • Every day, the doctor reviews the data on a web interface at the healthcare facility, identifies children at risk, and indicates those that he would like to see.
  • When children are called in by the doctor, families are warned by the agent and prompted to go to the health centre. Pesinet covers the full cost of the doctor examination and half of the cost of the medication.
  • Agents also organize monthly gatherings of mothers to discuss program and health issues.

Families subscribe for this service on a voluntary basis. The monthly price for the whole package of services is 500FCFA (USD $0.95) per child, the equivalent of a kilo of onions, a price affordable to low-income families in Bamako.

Activities are organized in small operational sites. In each area, Pesinet works with the referring local primary health structure, in line with the Malian health zoning. Each site is managed by a supervisor.

The current service is designed for urban areas. It can be deployed in rural areas with some adaptations. Pesinet is also developing a service for pregnant women. Following an evaluation of the pilot and a feasibility study, PESINET extend its activities to the districts of Dravela and Ouolofobougou.

Program history: 

When Pesinet was created, the 3 founders were willing to design a system to detect children diseases via monitoring of simple health data to reduce child mortality. After experimenting the service with a private doctor, it was realized that it created a huge incentive for families to seek medical care. That is when community healthcare centers started to see Pesinet as a solution for their endemic under-use issues and expressed their desire to host the Pesinet service. At that time, it was realized that if the service was to be integrated in the network of primary health centers around the country, it could drive a systemic improvement, as population would resort to care earlier on and healthcare centers would secure their revenues and ability to supply quality health services.

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