Strengthening District Support to the Micronutrient Program in a Low Income Setting: Rural Mali (West Africa).

ABSTRACT

Objectives: Since 2003, the Malian Ministry of Health (MoH) and its partners have adopted and scaled up a national program to deliver Vitamin A Supplementation (VAS) to children 6-59 months and post-partum women. The programme has achieved consistently high coverage of over 90%, however the majority of funding for implementation is provided by partners. The MoH has identified the need to increase country ownership of the VAS programme to increase programme sustainability. Methods: District level advocacy workshops were held in two regions with district health teams, local administration and civil society participants. The workshops, facilitated by the National Division of Nutrition and HKI Mali, provided information to participants to increase their awareness of VAS and encourage the mobilization of local resources to support VAS programme activities. Seven workshops were held one month before the most recent national Child Health Days (CHDs) with a total of 455 participants. Results: 178 district stakeholders committed to allocate additional resources to VAS distribution events, including allowances for distributers, fuel for supervision vehicles, transport for social mobilizers, and health supplies for VAS distribution. Decision makers also initiated local solutions for service delivery of VAS distribution, including covering the fuel cost for vaccinators, increasing local social mobilization efforts and adding a budget line for VAS activities in the community development plan. Conclusions: Advocacy efforts were effective in increasing resources allocated to VAS distribution and demonstrated an increase in local engagement at the district level.