22/09/2020
Mzia Turashvili, Pilar Duch, Mathias Altmann

This report examines the case study of Decentralised Models of Care (DMC) implemented in the MSF Operational Centre Barcelona (OCBA) Malakal project in South Sudan.

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 Malakal project

MSF-OCBA has been running Malakal project since 2013, supporting primary and secondary healthcare services in Malakal town. DMC components were introduced in 2017 in the periphery and by January 2020, consisted of six community health workers covering the three main killers (malaria, pneumonia, diarrhoea), nutrition for children aged under five, kala azar, and a referral system.