Pesinet is a not-for-profit international organization delivering a simple prevention and early-care system for countries lacking medical resources with the objective of driving a systemic change in the healthcare situation of low-income countries and reducing child mortality.

Pesinet was designed to offset the weaknesses of existing public healthcare systems and provide affordable healthcare services to help prevent, detect and treat diseases in time thanks to the periodic and cost-efficient monitoring of key health data.

Our mission is to avoid complications of benign diseases that still account for more than 50% of child mortality causes in Africa.
>> Read more about the social need we address

Pesinet uses mobile technologies and the proximity work of health agents from the communities served to reach families where they live and work and drive demand for early-treatment.
>> Read more about our innovative solution

Child mortality is a prevalent problem in Africa where, in most countries, more than 100 children out of a thousand die before their first birthday. In Mali where our project started, 1 child out of 5 does not reach the age of 5.

This is not due to major epidemics but, in 70 % of cases, to diseases that can very easily be treated if detected early enough. It’s an aberration as affordable treatment and staff qualified to treat those diseases are available locally.

More than 50% of child mortality in Africa is preventable.

Malaria, pneumonia and diarrheal diseases together account for 55% of children deaths in Africa (60% in Mali). Those benign infectious diseases are highly and quickly lethal when children are less than one year old. Indirect causes also heavily contribute to mortality.
Malnutrition is responsible for 51% of deaths and is known to be a triggering or a worsening factor for other infectious diseases.

55% of children’s mortality causes can be detected easily by checking periodically basic symptoms, in particular the evolution of their weight, which is known to be an accurate indicator of young children’s health status.

>> Why this situation?

Patients in Africa usually come too late to the doctor.

• Conventional medecine is seen by families as unaffordable.
• They tend to opt for auto-medication and traditional medicine that often prove inefficient.
• In doing so, they increase the risk of critical complications and end-up paying much more for late emergency treatment than if they had gone to the doctor in the first place.
• Public authorities have tried and built numerous Community Health Centers (CSCOM) to provide a minimum set of medical services to the population, these structures lack resources to supply preventive in addition to curative services.

>> Our funding idea: if diseases were detected and treated earlier on, mortality could be dramatically reduced with the need for risky and costly emergency treatment being decreased, and health spending for households would be lower.

With two of the United Nations Millennium Development Goals dedicated to the issue, maternal and child mortality reduction has been a priority of international engagement, but remains terribly high and stagnant, especially in Africa.

Child mortality is a terrible burden in Western and Central Africa, with the highest under-five mortality recorded worldwide.

A woman dies of pregancy-related complications every minute of every day in the world. Out of 514,000 deaths each year, 47% occur in Africa, mainly in Sub-Saharan countries.

Most children and mothers die of benign diseases for which affordable treatment exists. Overall, more than half deaths could be avoided with frequent prevention, efficient detection of abnormalities and provision of adapted basic treatment in time.

Our objectives are to:
>> Reduce child and maternal mortality
>> Facilitate access to early-treatment
>> Raise awareness of prevention

-> Read what Pesinet is doing to help prevent complication of benign diseases.

Pesinet’s founding idea is that if diseases were detected and treated earlier on, mortality could be dramatically reduced with the need for risky and costly emergency treatment being decreased and the annual health spending for the households reduced.

This is the reason why we developed a prevention and early-detection service that reaches families that would have come to late to the doctor to drive demand for and faciliate access to early treatment.

Pesinet’s key operating principles are to:

• Break away from a free-assistance approach in the healthcare area
  Families commit to pay a monthly subscription fee for the medical follow-up of their child. Free care has shown little impact on mortality rates in the last 20 years. With a paying service, Pesinet wants to help raise the value of prevention and bring about a systemic change in the healthcare situation of emerging countries.
• Offer a regular medical follow-up
  Health check-up by Pesinet’s agents are carried out every week, twice a week for children under 1. Timely monitoring of key health data allows early detection and treatment and thus prevent benign illnesses from getting critical.
• Work in partnership with local organisations:
  Our services are a full part of the local healthcare environment. Pesinet defines itself as a public service partner that strengthens existing public health policies and community structures.
• Ensure project sustainability and contribute to local economic development:
  The service is directly managed by locally hired people and has been designed to be financially self-sustaining.

Pesinet uses mobile technologies and the proximity work of health agents from the communities served to reach families where they live and work and drive demand for early-treatment.

The service encourages families to get to the doctor as soon as the first symptoms occur and facilitate access to affordable care by partnering with existing community-based public healthcare structures.

>> A unique package of healthcare services
From prevention to early-treatment and follow-up, Pesinet offers a comprehensive healthcare service for low-income families.
>> Innovative use of mobile and internet technologies
Pesinet uses mobile and internet technologies and the work of proximity health agents trained in house to bypass the lack of medical resources.

Pesinet offers a unique package of healthcare service including prevention, early-detection, treatment and follow-up as well as a financing mechanism that allows affordable access to healthcare.

• A periodic health follow-up backed to a distant database

Proximity agents visit children every week, twice a week for children under one. The visit is either made at home or in an everyday place like schools or markets where people gather and where the agent can easily find mothers and children. Gathered data is sent daily to a secure, centralized database.

In case an emergency is identified by the agent, it is indicated in the mobile application and an «emergency ticket» is given to the patient to come and see the doctor the very same day.

• A medical examination for free in case of illness and access to discounted medication

Patients in Mali usually come to the doctor when it is too late. It is too resource-intensive for the practitioner to do a frequent tour to follow-up on families’ health because homes are dispersed and medical personnel is scarce. With Pesinet, the doctor has access to hundreds files in less than 2 hours every day, right from his working place. This multiplies one doctor’s capacities and bypass the lack of trained medical personne

• A mutual health insurance system

Subscribers pay a monthly fee of less than a euro to get access to the whole service: periodic health check-up by agent, remote monitoring, medical examination and access to discounted medication. This is less than current average health budget per person and builds the basis for a new perception of prevention’s value.

• A hygiene and sanitation awareness-raising program

Agents are trained to spread good practices on hygiene and sanitation. They lead by example in their daily work, encourage simple changes like hand-washing, sleeping under mosquito nets and raise awareness of mothers on the importance of breast-feeding for young children’s nutrition.

>> See the key steps of the Pesinet health monitoring service

>> Watch how it works in the field

Pesinet’s service leverages the quality GSM network in Africa and open-source software to record and transfer information and then reduce the amount of time a doctor needs to access and analyze it.

A mobile application has been developed to collect and transfer data on the ground by Pesinet’s agents. An online application linked to a database allows for remote monitoring of health data by the local doctor, activity management and tracking of key impact indicators.

Data flows go through three steps:

Data collection
Health agents record data on their mobile phones via a customised JAVA applet designed to be easy to download, install and use.

The phone keeps track of each subscriber so that the agents can easily access and update recorded information on a patient.

Data transfer and treatment
Each day, proximity health agents send the data through the GPRS network to a central server. Pesinet pays for the bandwidth used and manages the server infrastructure.

Display and features
Collected information is made available through a web interface with two main features: pre-sorting and flagging of abnormal cases and generation of medical records

Activity management and administration
Program coordinators can administrate the service and monitor the collection and the enrolment processes. Automatically generated activity reports ease remote follow-up by each management level. The systems also allows monitoring of key progress indicators on Pesinet’s impact. Data is aggregated and statistics displayed in restricted access at different levels (by program, by region, by country).

For a monthly fee of less than 1 euro, the equivalent of a day of earning for 90% of Malian, families access:

• a weekly health check-up of their child by our agents
• free medical examination whenever the doctor remotely identifies abnormalities
• discounted medication to treat the child
• free follow-up examination if needed

In countries where most people do not benefit from social security and where 70% of the cost of healthcare relies on families, offering an affordable mutual insurance system to facilitate access to treatment can dramatically change perception of the value of prevention and encourage families to get to the doctor as soon as the first symptoms occur.

Pesinet is a paying service to allow financial self-sustainability of the service on the ground and job creation in the communities covered. Monthly fees paid by families cover the cost of the program when 1000 subscribers are reached. Start-up funds, training and technical assistance for each sites are paid thanks to grant-funding from our donors.

Watch the flash animation and read a summary of the key steps of the Pesinet health services.

>> Our proximity health agents periodically weigh children, check symptoms of generic diseases on pregnant women and spread hygiene and sanitation practices.

>> Health data is transferred in real-time and presented to the doctor of the nearest Community Health Center through a website that flags abnormalities.

>> Families access free doctor examination and half-price medication within 24 hours after check-up.

>> Subscribers pay an affordable monthly fee for the service – less than 1€, the equivalent of a day of work for 90% of Malian people.

>> Each Pesinet site allows to follow-up on the health of over 1000 subscribers.