“Losing a child to malaria is every parent’s nightmare,” says Maïmouna, a mother of 4, who remembers the hopeless nights and tragedies that have forever marked her neighbors.
It is a nightmare all too real for many parents in rural Senegal, where health facilities are either under-resourced or simply non-existent. This lack of services means that preventable diseases such as malaria remain the primary killer of children under 5.
In communities across Senegal, volunteers are rising as agents of their own health to change this.
Dieynaba Sow is part of a growing corps of community health workers who have transformed health care delivery in remote communities by providing lifesaving treatment in challenging rural settings. Their ability to respond immediately eliminates potentially deadly delays – malaria can kill a child if treatment is not provided 24 hours after the onset of symptoms. In the district of Kayar, where Dieynaba operates, many communities are isolated because of poor road conditions. Imagine the anguish of parents trying to rush their fever-stricken child for treatment, only to be stuck for hours in a precarious horse cart on nearly impassible roads.
The PECADOM initiative (Prise en Charge à Domicile - home care) was introduced in Senegal in the late 2000s as a pilot to address barriers to healthcare in rural areas. The initiative is being rolled out across the country with strategies that are tailored to the epidemiological and social context of each area.
Community health workers are elected by their neighbors and trained to treat malaria, pneumonia and diarrhea, three of Senegal’s primary killers of children under 5. They are equipped with rapid diagnostic tests and quality-assured medicine to administer appropriate treatment at the first sign of symptoms. Early diagnosis and rapid treatment provided by these volunteers has drastically reduced the number of malaria cases, which are becoming increasingly rare in Kayar and surrounding villages. Dieynaba’s village has recorded a striking drop over the last few years.
Senegal’s commitment to expand health services deeper into its underserved communities has produced transformative results, particularly when it comes to the fight against malaria. Malaria death rates have fallen by 59 percent since 2002, and 33 districts have reached the pre-elimination stage by the end of 2016. This is a milestone that indicates transmission rates have dropped sufficiently to start shifting programs from a control stance to the goal of elimination.
It is owed in large part to the deployment of more than 25,000 community workers across the country. As caregivers and educators, they play a fundamental role: they distribute mosquito nets, demonstrate how to properly tuck them under sleeping mats and mattresses, visit patients at home and hold sessions on malaria prevention and treatment. They refer severe cases and other diseases to the nearest health center, urging people not to wait until symptoms worsen, but instead to seek treatment as early as possible.
Community health workers have demonstrated their unique ability to provide access to health services beyond the mainstream facilities and build long-lasting trust with patients. They bring health care where it didn’t exist. “Four years ago, there were no roads connecting our village to the health post,” says the chief of Djokhop Guedj, a village that benefits from Dieynaba’s services. “Those who were lucky to make it would line up for days outside of the post, desperately waiting to receive care. Now, we have Dieynaba. Her door is open night and day to keep our community healthy.”
Amadou Ka, known as “Dr. Ka” is the head nurse in Kayar. During the fishing season, the district attracts thousands of migrant workers from across Senegal and neighboring countries. He can attest to those long lines and desperate waits. “We used to run out of beds, we had so many severe malaria cases,” he says.
Dr. Ka lives on site at the health post to provide 24/7 care to patients. During the peak fishing season, the population of Kayar triples to reach nearly 60,000 people – all relying on this single, understaffed health post to receive lifesaving care. “Having health agents living within communities is life-changing,” he says.
Malaria threatens children’s education. Thanks to health volunteers’ relentless efforts to verify that all school-age children sleep under mosquito nets during the rainy season, when the disease strikes most, school absenteeism and child mortality rates have been reduced to nearly zero in 80 villages near Kayar. By bringing care closer to the people, community health workers are helping put an end to parents’ nightmares and give flight to children’s dreams.
© 2026 The Global Fund
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