Summary

Program goals

Djantoli'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. By addressing the issue from the demand perspective and reconnecting people with healthcare structures, Djantoli aims at generating a systemic change in the healthcare situation of Sub-Saharan countries.

Key program components

Djantoli has developed a service for children under 5 that is currently deployed in Bamako, Mali. The program leverages simple mobile technologies as well as community agents to enable remote monitoring by the local doctor, accelerate disease detection, and facilitate early access to basic medical care.

Working in the 3rd District of Bamako, Djantoli has enrolled 800 children in the service, which works as follows:

• Every week, Djantoli'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. Djantoli 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, Djantoli 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. Djantoli is also developing a service for pregnant women. Following an evaluation of the pilot and a feasibility study, Djantoli extended its activities to the districts of Dravela and Ouolofobougou in October 2012.

When Djantoli 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 Djantoli as a solution for their endemic under-use issues and expressed their desire to host the Djantoli 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.

Since 2009, over 1400 children have been enrolled in Djantoli by their parents; 900 children are actively being served.