Survival of the Trusted: Africare/Benin Goes from Near Shut-Down to Benin’s Lead Malaria Partner

In 2006, Africare/Benin was on the verge of closing. Africare had only one active project in the country, and the cost of maintaining an office was becoming untenable. Eight years later, Africare/Benin has six offices and implements malaria projects in partnership with the national government, 24 local non-governmental organizations (NGOs) and more than 2,500 community-based organizations. What happened? The people of Benin asked us to stay.

National Selection

In 2002, Dr. Josette Vignon Makong was Africare’s health program manager in Benin. She assisted the Benin country director in monitoring and evaluating the results of Africare/Benin’s health projects. In 2004, the work of Dr. Vignon Makong and her colleagues successfully secured a project grant from The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

The Global Fund didn’t decide what organization to award with funding though – the people of Benin did. Benin’s Country Coordinating Mechanism (CCM) consists of representatives from local government ministries, NGOs and communities, including members of the local population who are living with diseases such as malaria, tuberculosis and HIV. It is the members of the CCM who decide which organization will implement a Global Fund project, and in 2004 they chose Africare, the first international NGO to win a Global Fund grant in Benin.

The name “Africare” is one that the communities in Benin trust. For example, in the late 1990s Africare flipped malaria prevention on its head with a pilot project that instead of placing malaria medication only in the hands of physicians, delivered it directly to community members trained to become Community Relays, who recognized and treated simple cases of malaria that didn’t need a clinician. The model was so successful that Benin adopted it as a national policy.

Repeatable Results

The model’s effectiveness and the trust it fostered were major reasons why the CCM chose Africare in 2004, and Africare/Benin delivered on its promises despite logistical constraints. In 2006, Dr. Vignon Makong, at that point in charge of Africare’s Global Fund project implementation, was coordinating work in two geographical departments out of her home while a staff of only 11 people operated out of borrowed space in a District Health Office. The project’s field work was about two hours from where Dr. Vignon Makong lived in Cotonou, but she made round trips three to four days every week. For years, the staff’s dedication and the project’s success reminded people that Africare was still present and was not leaving Benin.

Africare’s Global Fund project targeted children and pregnant women in Mono and Couffo departments, reaching almost 76,000 children with artemisinin combination therapy (ACT), providing more than 55,600 women with preventive treatment during pregnancy and distributing more than 214,200 insecticide-treated nets. Although national severe malaria incidence increased 65%, in Africare target areas the rate plummeted 73%. Also, malaria-related mortality in children under 5 in our target areas fell 84%, substantially surpassing the national 18% decrease.

Impressed with the results, The Global Fund recognized the project’s potential for greater impact and declared Benin eligible for funding in 2008 to scale up Africare’s proven strategy nationally. Some competitors had doubts that Africare could deliver at such a large scale, but again Benin’s CCM decided to continue with Africare as the principal recipient of the six-year expansion project. Today Africare/Benin operates out of five regional offices plus one home office in the country’s largest city, Cotonou, with 104 employees, 100% Beninese.

Investing in the Future, Defeating Malaria

As Africare/Benin’s country director, Dr. Vignon Makong now oversees Africare’s participation in two major malaria initiatives, including the Global Fund project we lead that began in 2004 and now covers 20 of the nation’s 34 health zones. Through Africare’s capacity building work among community groups, hundreds of thousands of ailing children have recovered with ACT and millions are sleeping under long lasting insecticide treated bed nets.

After a successful campaign in 2012 that delivered 4.9 million long lasting insecticide treated bed nets to the general population, this July Africare/Benin will collaborate with Benin’s National Malaria Control Program for a second national bed net distribution with more than five million bed nets to be procured by Africare. Africare is proud to have been repeatedly selected by Benin’s CCM, and we are grateful for the opportunity to partner with the international donor community and national stakeholders to defeat malaria. The people of Benin invested in Africare’s growth, and we will continue to invest in the growth of Benin.

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