Community Health Worker Changes Attitudes about Community Medicine in Benin

Community Health Worker Changes Attitudes about Community Medicine in Benin

Orou Assoumanou describing the work within his community to Dr. Lola Gandaho, of BASICS Benin.


Living in the rural village of Kpagnaroung, Benin, Orou Assoumanou is a dedicated health worker who promoted vaccinations and distributed ivermectin (a medicine used to treat roundworm) within his community before receiving training by the MSH-led, USAID BASICS (Basic Support for Institutionalizing Child Survival) project in community-case management. The comprehensive BASICS training improved his ability to offer care and enabled him to treat children within his community.

With the arrival of a trained community health worker able to prescribe medications, members of his community no longer have to travel long distances to seek medical care for their children. In fact, Orou says that crowds would form at his door to receive care.





Kpagnaroung (marked by the star) is a rural community in Benin.


Despite this success, there were still several people in the village who remained reluctant. “The mother of a 15-month-old boy brought her son to me because he was suffering from diarrhea. After checking for signs of immediate danger, I reassured the mother that oral rehydration salts (ORS) and zinc therapy would treat her son,” said Orou.

He was able to offer these kits at low, subsidized prices but was surprised that the mother became more uncomfortable following his offer. She told him that she did not have the 125 FCFA (about 25 cents) to pay for the medications. Orou advised the mother to return to her home and ask her husband for the money. He told the mother to continue breastfeeding and increase fluid intake, as well.

She returned several minutes later, saying that her husband was unwilling to give her the money. Orou then accompanied her to see her husband and explained to him the severity of leaving his son untreated and the threat of death from dehydration. The father still refused to pay for the medications, citing that he had a large family and had recently suffered financial loss from two lost cows.

“I felt ashamed that I had to bear this failure,” said Orou, “and I imagined that the child's condition would worsen. But I had tried everything and the father would not listen.” In an effort to create project sustainability, Orou must receive payment for distributing these medications.

Within a few days, Orou received a visit from the father, who came to apologize. He explained that his child's diarrhea had persisted and that his health had rapidly deteriorated. The child became unresponsive and was barely able to breathe. Realizing his child's life was in danger, the father took him to the nearest city hospital, about 30 miles away, where he spent 25,000 FCFA (about $50 USD) for treatment.

Since this event, the father's attitude towards seeking community-case management has changed. Orou demonstrated the value that community health workers trained in community case management can have on several levels of a family's health, including financially. He now uses this lesson as an argument for beginning immediate care of sick children within his community.

Dr. Lola Gandaho wrote this blog post. She is the Technical Child Health Advisor for BASICS Benin. Kaj Gass, US Peace Corps Volunteer, also contributed to this blog post.