Pesinet Child Mortality Pilot Programme

According to Persinet, there are three main barriers to medical treatment for children in Mali. The first is a geographic barrier, particularly in rural areas. The second is family finances, and the third is what organisers call an "attitude barrier" - many people wait until illnesses are severe before visiting a doctor. The objective behind Pesinet's system is to overcome all three barriers. First, healthcare agents directly visit homes of children enrolled in the programme so that families don't have to go to a healthcare centre. Second, families pay a nominal monthly fee to enrol, which acts as micro-insurance covering the healthcare agents' visits, doctor's visits, and half the price of medication (if a child needs it). Finally, agents make home visits weekly, so potential illnesses can be detected early.

The healthcare agents carry mobile phones on their visit. They look for five key symptoms (fever, vomiting, diarrhoea, coughs, and weight loss), record the data on a Java mobile application, then send the data to a doctor at the local health care centre. Organisers say the system is designed to be simple and easy to use. Once the doctor receives the agents' data, he or she can provide immediate feedback and recommendations. The mobile technology allows for a model where a greater number of children can be reached with just one doctor.

Click here to view a short flash animation which explains the key steps of the Pesinet service of early detection and treatment of children's illnesses.

Child Mortality, New Technologies

Organisers say the programme has faced challenges in its pilot phase, primarily in creating trust among potential subscribers in a no-prevention culture, and in creating a self-sustaining business plan. It takes a long time to build trust with families and convince them that micro-insurance is a worthwhile investment. Although the price of the programme is kept low in order to remain affordable for families, this means that the break-even point can only be reached with a great volume of children enrolled. Organisers estimate the programme will be able to self-support once it reaches 1,500 children (with six healthcare agents) or 2,000 children (with ten healthcare agents).

In addition, the programme only covers the top three illnesses that result in child mortality (respiratory illnesses, diarrhoeal diseases, and malaria); and treatment for chronic diseases is not included in the half-priced medication coverage. However, according to a study performed by the Malian Ministry of health, 96% of the mothers enrolled in the programme reported being satisfied with the service, and 99% said they would recommend Pesinet to friends and family.