The roll-out of a national community health policy marks a transformative step forward in healthcare access in Benin.
At its core are community health workers and qualified community health agents (ASCQs), trained to deliver a range of services such as home visits, health awareness sessions, mass campaigns and patient referrals. These frontliners also play an irreplaceable role in strengthening routine immunisation, particularly in extending vaccine protection to children who have never received a single dose – commonly referred to as zero-dose children.
For Roland Houndété, a community health worker, that part of his mission is especially rewarding: “What I love most is tracking down zero-dose children and bringing them back into the vaccination programme. It’s fulfilling to know I’ve convinced parents of the importance of vaccinating their children.”
“People used to oppose us, but now they even report unvaccinated children. It shows our message is getting through.”
– Rosine Ekloutché, community health worker
Community health workers tackle the zero-dose challenge
Routine immunisation has long been a challenge in Benin. Over 100,000 children were reported as unvaccinated between 2020 and 2022. By bringing vaccination services closer to communities following the launch, in June 2023, of the community health policy, the government aims to uphold the fundamental right to quality healthcare for every citizen.
Thanks to community health workers, progress is tangible. In the Zou region, the local health director reported that 38,588 zero-dose children had been reached with protective vaccines, leaving 3,752 yet to be reached. Among under-vaccinated children, 35,977 have been caught up, with 6,363 still to go. Beyond vaccination, this approach improves access to mosquito nets, basic hygiene and epidemic response measures.
During a recent visit to Benin, Colette Selman, director of Gavi’s Core Countries programme, praised the dedication of community health workers and the warm reception they receive from households. “What I’ve seen here is encouraging. While challenges remain, the results show this community-based approach is making a real difference,” she noted.
“I didn’t believe in vaccines, but once I understood their importance, I changed my mind. Now, I talk to other mothers in the market.”
– Mirma Djogbénou, fish seller
A bold vision for community health
Benin’s strategy centres on prevention and health promotion, supported by a permanent community surveillance system. The initiative has deployed 1,500 community health workers and 37 ASCQs nationwide. “Each community worker is responsible for about 200 households, which they visit weekly to detect health issues, provide guidance and distribute medical supplies,” explained Benjamin Hounkpatin, Benin’s Minister of Health.
In the Zou region, particularly in Abomey, these workers are tirelessly committed to improving community well-being. During meetings in late November 2024 with visiting officials from Gavi, UNICEF and WHO, health leaders highlighted the programme’s success.
In harder-to-reach areas, like the lake village of Sô-Ava, attitudes toward vaccination have shifted, they were able to report. Once hostile to health workers, the community now collaborates to protect children’s health. “The community health policy has broken down barriers and addressed major local challenges,” said Conrad Déguénon, Director of Hygiene and Community Health.
“What I love most is tracking down zero-dose children and bringing them back into the vaccination programme. It’s fulfilling to know I’ve convinced parents of the importance of vaccinating their children.”
– Roland Houndété, community health worker
Rosine Ekloutché, a community worker, notes the progress: “People used to oppose us, but now they even report unvaccinated children. It shows our message is getting through.” For parents, too, the change is clear. Fish seller Mirma Djogbénou recalls, “I didn’t believe in vaccines, but once I understood their importance, I changed my mind. Now, I talk to other mothers in the market.”
A key partner in these efforts, Gavi has invested a total of nearly US$ 300 million in Benin, bolstering immunisation systems and reducing child mortality. The organisation plans further support, including training 1,400 new community health workers and providing bicycles and motorboats to reach remote areas.
Translated from the original French version
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