Senegal: Successful task shifting for the implementation of community IMCI – The community health educator

BACKGROUND. Despite its high child mortality, the implementation of the community IMCI approach in Senegal had no significant difference in the coverage of services partly due to the absence of front-line health workers THE SOLUTION. Plan International, a child-centered humanitarian organization, has piloted a new type of front-line health worker, called the community health educator (CHE), since 1998. A CHE has 10 years of education and previous working experience in community development to be a conduit between the government health facilities and communities. CHEs are private providers and associate into local NGOs to negotiate the delivery of a community-based package of activities with Plan International and the local government. Each CHE has a monthly allowance of about $ 200 U.S, paid by Plan International, and covers an area of about 40 villages. THE RESULTS. Currently, Plan International supports 120 CHE's covering a total of 1.5 million people. CHE's have been instrumental in (a) improving the completeness and timeliness in the reporting of community volunteers. (b) increasing the use of health services by 75% to 225% higher than populations not covered by them in the same district. (c) supporting community volunteers to follow the government standards for community IMCI, including patient referral and drug management and (d) helping to bridge the social gap between communities and the government. NEXT STEPS. Today, outside of financial support and monitoring, the management of the CHE's is made by communities and their local governments including the funding of the CHE's in their budgets.