Agente SantÃ© Maternelle (ASM) are one of four types of Rwandan Community Health Workers (CHWs) which include community case management and social mobilization workers who are selected by their own villagers and serve as volunteers.
ASM identify, follow, educate and refer pregnant women in their villages to the nearest health center. During the USAID ACCESS Project in Rwanda, Jhpiego assisted the Ministry of Health to adapt UNICEF training materials for ASMs. MCHIP is continuing the work and focuses on training and kitting ASMs in five Districts.
Alphonsine, an ASM from Karubondo village near Gikondo Health Center keeps a record book of pregnant women she is following. Her village has 179 households, 696 residents and 124 women of reproductive age (WRA).
The program ensures that ASM have manageable case loads. Since her training by MCHIP in August 2011, Alphonsine has seen 17 clients and now is following 9 pregnant women.
Health education materials such as a flipchart for the ASMs include emphasis on bednet use and prompt treatment of fevers. AMS also have a carry bag, boots, umbrella, thermometer, and a torch.
Some women are reluctant to reveal their pregnancies because of social issues like being a widow or a teenager. The AMS must work hard to gain trust so women confide in her. Volunteer work as ASM must fit in with her hard work as a farmer.
ASMs encourage women to attend Antenatal Care at nearest clinic. There they will reveive free bednets. The ASM then educates the women on proper and regular net use. The ASM also refers women with danger signs in pregnancy to ANC. Such signs may be high temperature for which proper testing and treatment is needed if they have malaria.
Rwanda is closing in on malaria elimination. The various kinds of CHWs play an important role in prevention, case detection and assurance of appropriate treatment. Community vigilance is a crucial component of eliminating the disease.