Louise Sambieni, a woman living in the village of Kountori, Atacora Department, Benin, was unable to afford the medicine she needed when she fell ill with malaria.
“A few months ago, while I was walking to the field where I work, I started to have a headache…The headache lingered and my husband suggested that I go to see a doctor and gave me 5,000 francs for care....The drugs that the doctor prescribed not only cost more than 12,000 francs, they were also unavailable in my village and I would have had to travel to Cobly, 17 km away, to buy them. I was not able to do so as I didn’t have the money for the drugs or to get to Cobly.”
Fortunately, as a member of the Tilyikna Women’s Group, an organization representing 50 women, Louise had somewhere to turn.
“I was able to ask for 10,000 francs [to buy the necessary drugs] and these funds have saved my life.”
Malaria, an infectious disease spread by mosquitoes, is a major public health issue in Benin. According to the country’s annual statistical data for 2019, the malaria morbidity rate is 45.5 percent across the general population and 48.8 percent among children under five. Severe malaria cases represent 23.1 percent of deaths in the country—and the rate is even higher for children under five, at 33.9 percent.
While malaria can be managed and treated, accessing treatment, which can be as high as tens of thousands of CFA francs and may not be available locally, remains out of reach for the majority of the population.
This was the issue that the U.S. Agency for International Development (USAID) Integrated Health Services Activity (IHSA), led by Management Sciences for Health, had to address. In Benin, through the Activity, USAID is supporting the Departmental Directorate for Social Affairs and Microfinance (Direction départementale des Affaires sociales et de la Microfinance)’s centres de promotion sociale as well as communes in four departments (Alibori, Atacora, Ouémé, and Plateau) to provide access to quality care to the population. Knowing that one of the biggest challenges is paying for treatment, the Activity first suggested implementing income-generating initiatives, beginning with the least privileged groups—women and youth.
Strategies for implementing these initiatives included conducting training sessions on how to process raw material into food products—such as processing soy into cheese—and on building women’s financial management capacity, including how to manage profits and losses, generate profits, and create strategies for saving a percentage of the money earned.
The profits generated and the money saved by the supported women’s groups has helped them to create health savings funds. The objective of this fund is to provide group members with a constant reserve of cash that they can use at any time to pay for care and medication. This type of fund proved to be useful immediately, as evidenced by Louise’s experience.
Between August 2020 and January 2021, the women’s group of Tilyikna saved 76,300 CFA francs in its health savings fund, which has benefitted Louise and other members who have needed support. Thanks to the system and training, these women now have immediate access to funds as well as the capacity to pay back their loans with the money they earn through income-generating activities.
Access to health savings funds is lifesaving, especially when a child is suffering from a severe case of malaria. Limata Malik, president of the Iréti’mbè and Ifèomontayo group (Adja-Ouèrè, department of Plateau) shares her experience of when her grandson was very sick:
“I didn’t have any money left. I went to the group that I belong to and they gave me a 10,000-franc loan from our health savings fund. With this money, I went to see my daughter and son in-law who were struggling to pay for the lab tests and prescriptions. Very quickly, those 10,000 francs were gone and I had to secure another loan from one of the people in charge of the group. We spent three days in the hospital but my grandson eventually got better. I’m very thankful to the group for the support that they provided. I don’t know what would have happened to my grandson without their support.”
In addition to implementing health savings funds, the United States Government, through the work of the Activity and its technical advisors, is also conducting awareness activities for the groups on prevention, hygiene, and the effective use of long-lasting insecticidal nets. Through this support, the Activity is supporting a rapid response to access to quality antimalarial care that is sustainable and helps the community be economically self-reliant.