17/09/2020
Heidi Becher, Pilar Duch and Mathias Altmann

This report examines the case study of Decentralised Models of Care (DMC) implemented in the MSF Operational Centre Barcelona (OCBA) Kabo project in Central African Republic (CAR).

It is part of a wider evaluation that was commissioned to draw lessons learnt from three MSF projects and improve current and future DMC interventions. Specific objectives included evaluating the effect of changes in access to healthcare, effects of DMC on higher levels of care, community participation/involvement, community perception of DMC activities and specific aspects of the DMC strategy. Evaluation criteria covered relevance, appropriateness and effectiveness.

What is DMC?

MSF OCBA understands Decentralised Models of Care (DMC) as health services implemented outside medical facilities and delivered closer to patients in the community, in order to make curative and preventive medical activities more accessible.

Overview of Kabo project

MSF-OCBA has been running Kabo project since 2006, to reduce morbidity and mortality in the Kabo and Moyen Sido area. DMC components were introduced in 2015, and by the end of 2019 had evolved into 31 community treatment points managed by community health workers, health promotion activities, decentralised antenatal care, vaccination outreach activities, and community antiretroviral groups (CAGs).