The World Health Organization (WHO) created the Rapid Access Expansion Program (RAcE) in 2012 to prevent children’s deaths in remote areas of Africa. RAcE trains health workers to care for children suffering from malaria, pneumonia, diarrhea and malnutrition. This program is necessary, as it is estimated that one-third of the 2.9 million children who died in Africa in 2015 could have survived if they had access to healthcare.
RAcE integrates the diagnosis, treatment and referral of children who initially present with a fever. Research shows that this system increases rates of necessary treatments for malaria and catches diseases that may also present with a fever, such as pneumonia and diarrhea. These three diseases are curable if diagnosed and treated early enough. This style of treatment is also more cost-effective.
The program is implemented in a five-year plan and is currently expanding in five countries: the Democratic Republic of the Congo, Malawi, Mozambique, Niger and Nigeria. RAcE works with the governments of these countries to train health care workers and create evaluation systems in remote areas. These countries have many rural villages whose occupants cannot easily access a health center.
Community health workers get trained and live in the community where they work. These areas are often rural and difficult to access. The community health workers become a valuable resource for people in the village who might not have access to healthcare otherwise. The volunteers are trained to diagnose malaria with a rapid test and treat children with as artemisinin-based combination therapy. Health workers treat diarrhea with oral rehydration salts and zinc. If health professionals recognize the signs of pneumonia, they treat it with amoxicillin.
So far, RAcE has produced promising results. Over six million correct diagnoses of malaria, pneumonia and diarrhea have been recorded. The under-five mortality rate in has dropped 53 percent globally since 2000. Nearly 8,400 community health workers are trained to work in integrated treatment for children. Some countries have altered their national health policies to use rapid diagnostic tests for malaria and amoxicillin in community health care practices.
Perhaps most importantly, the Rapid Access Expansion Program has provided information on how to scale up an integrated treatment system. RAcE depends on many organizations to provide training, supplies and monitoring systems. Each of these organizations researched the best way to train workers and set up their facility.
For example, the program in Malawi studied several variants to understand how the program could be expanded to a national level. Nongovernmental organizations or governments that want to attempt integrated community healthcare can learn from these studies. The Democratic Republic of the Congo and Nigeria plan to expand their programs based on the evaluations from RAcE.
– Sarah Denning