Muso

Muso's mission is to eliminate preventable deaths rooted in poverty. Working with the Malian Ministry of Health, we have created a Proactive Care health system optimized to save lives by reaching patients early in the course of their illness. Muso provides life-saving health care to more than 350,000 of the world's most vulnerable people in Mali; conducts and disseminates research to guide global best practices for community health programs; and provides technical assistance to policymakers and implementers who wish to adopt the strategies we develop and test, including supporting health systems reaching over 45 million people in Mali and Côte d’Ivoire. Building on the results we have observed in communities where we have worked since 2005, we have an opportunity to scale a global model for saving millions of lives.

Muso’s Proactive Care model is designed to be simple and adaptable--designed from the start for government implementation at scale. Through direct health care delivery, rigorous research to test our strategies, and technical assistance and advocacy, Muso supports governments to deliver evidence-based Proactive Care strategies. Muso's continued direct service and research will generate evidence that will enable us to support the Malian government, Ivorian government, and global partners to improve national health systems. We will put these critical findings into the hands of global policymakers, implementers, funders, and norm-setting bodies, toward a goal of ending delay in health care for tens of millions of patients.

Muso was founded in 2005 by a group of Malians and Americans who came together to address health injustices caused by poverty. In the subsequent years, Muso has become a global leader in building scalable health systems solutions. Muso has served the Malian Ministry of Health (MoH) as an operational research partner for more than a decade, working with the MoH to develop health systems innovations with the potential to improve early access to care, child survival, and other health outcomes. A recent study found that communities with access to our Proactive Care model observed the lowest child mortality rates in sub-Saharan Africa. Since 2005, we have grown from serving 100 people to reaching more than 350,000 patients across nine sites in Mali in 2021 through our Proactive Care model. We are collaborating with the Malian MoH and academic researchers to conduct one of the world's largest studies in community health to rigorously assess our impact, and guide national and global CHW scale-up. Through our partnership with the Malian government, we are supporting a redesign of the country’s primary care health system for its 19 million citizens. We are additionally launching a long-term partnership with the government of Côte d’Ivoire to strengthen the national health system reaching 26 million people. As we have done this, our Community Health Workers have delivered care through more than eight million home visits and nearly 850,000 clinic visits since 2008. They lead the world’s fastest health system: in 2021, our veteran CHWs treated 98% of children under five within 72 hours of their first symptom. Muso’s frontline health workers are supported by a team operating at the fulcrum of direct service, research, and policy change, and comprised of experts in community health systems design and scale-up, leading researchers and physicians, and experienced partnerships and operations leaders.

A 2018 study published in the journal BMJ Global Health found that communities where Muso works achieved a ten-fold increase in access to care, and achieved and sustained the lowest rate of child death in sub-Saharan Africa, ultimately reaching a rate of child death of 7/1000. To further test our strategies at scale, Muso and our partners launched one of the world’s largest research studies in community health. The ProCCM Trial will test the impact of Community Health Workers proactively finding patients on child mortality and other secondary indicators. Following 98,000 people across 137 cluster sites over three years, this study will collect tens of millions of data points, and produce findings to guide community health care delivery in Mali and around the world.

Together with the Malian government, Muso has documented a historic change in access to care and child survival in the communities with which we partner. Given these transformations, Muso is building bold partnerships to share evidence-based strategies with policymakers and implementers in Mali and around the world. We work to promulgate Proactive Care through the public sector, and to support policy and practice change through national and global uptake of evidence-based strategies. We have served as an operational research partner to the Malian government for more than a decade. In 2019, the Malian government committed to a national health system reform to bring universal health coverage to all of Mali’s 19 million citizens through a scale-up of strategies we have co-tested, including user fee removal, improved health facilities, and Community Health Worker rollout across the country. The quality backbone of this reform will be 360 Supervision, a CHW performance management and support strategy that Muso and the government developed, tested, and scaled. The ProCCM Trial will allow the government to further direct national policy and practice as new evidence emerges.

Muso shares our Proactive Care strategies and results across the global community to support partners who wish to implement our systems in policy and practice. In 2019, Muso began a 12-month technical assistance (TA) partnership with the government of Côte d’Ivoire. Our TA team supported the Ivorian government to adapt and prepare to scale dedicated CHW supervision nationally to support the country’s existing cadre of 11,000 CHWs and strengthen the foundation of the country’s health system. Muso and the Ivorian government recently committed to a new, long-term operational research and TA partnership in which we will together pursue rapid impact on health access and outcomes for the country’s 26 million people.