Accelerating Malaria Elimination
Addressing the 19% under-5 mortality burden through robust Operational Research, resolving "last-mile" delivery failures, and tackling behavioral barriers to ITN and IPTp usage.
Strengthening MNCH Primary Care
Moving beyond isolated interventions to integrate MNCH, Nutrition, and Family Planning into existing PHC infrastructure across 200+ upgraded facilities.
Real-Time Digital Surveillance
Leveraging the Dònuèsè Data Center for 72-hour rapid response triggers, predicting transmission spikes, and ensuring <5% stockouts of essential life-saving commodities.
156,000 Women Leaders Strong
Activating a massive grassroots network and Male Health Activists to drive community demand, dismantle gender barriers, and shift health-seeking behaviors.
The Dual Crisis in Francophone Africa
🦟 The Malaria Burden
Francophone West and Central Africa bears the highest global burden of malaria, accounting for 19% of all Under-5 Mortality in the region. Despite the availability of clinical tools, "last-mile" delivery often fails due to unmapped behavioral, social, and systemic barriers.
Key issues: ITN misuse, delayed care-seeking, ACT/RDT stockouts.
🩺 The MNCH Challenge
The region accounts for a critical share of the 1.78 million under-5 deaths annually. With a Maternal Mortality Rate (MMR) of 629 per 100,000 live births (the highest globally), weak health systems and fragmented funding leave millions of mothers and newborns highly vulnerable.
Key issues: Clinical capacity gaps, lack of essential medicines, weak referral systems.
RFLD's Systems Approach: Breaking the Cycle
For decades, global health interventions in Francophone Africa have operated in silos. Malaria programs deliver bed nets, while maternal health programs focus on clinic-based care. The Réseau des Femmes Leaders pour le Développement (RFLD) recognizes that women and children do not experience these health threats in isolation. A pregnant woman suffering from malaria is at a much higher risk of postpartum hemorrhage, and her child is at risk of low birth weight. Therefore, our proposed program integrates these interconnected challenges into a single, cohesive health system strengthening strategy.
Operating across 8 countries through our network of 450+ grassroots organizations and 156,000 frontline women leaders, we bridge the gap between national health policies and grassroots delivery. Our approach shifts the paradigm from top-down medical directives to bottom-up community ownership. We believe that clinical efficacy is useless without community adherence and behavioral acceptance. By decentralizing health delivery and placing the power of education and surveillance into the hands of local women leaders, we ensure that health solutions are culturally competent, widely accepted, and immediately actionable.
Furthermore, our approach integrates cutting-edge Operational Research (OR) directly with this massive community mobilization. Instead of waiting years for academic studies to trickle down to policy, we generate real-time evidence on why interventions—such as rapid diagnostic tests or antenatal supplements—succeed or fail in remote villages. We simultaneously deploy rapid, community-led solutions to fix these bottlenecks as soon as they are identified, ensuring a continuous loop of learning, adapting, and saving lives.
Malaria Elimination Strategy
We target the behavioral and systemic blind spots that cause standard interventions to fail at the last mile.
1. Operational Research & Insights
The global health community has excellent clinical tools for malaria, yet transmission remains stubbornly high. The missing link is understanding human behavior in real-world contexts. Our Operational Research (OR) utilizes Implementation Science methodologies to decode the "why" behind intervention failures.
- IPTp Hesitancy: Through deep anthropological mapping, we investigate the socio-cultural barriers preventing pregnant women from receiving the recommended 3+ doses of Intermittent Preventive Treatment. We analyze myths, religious beliefs, and facility-level deterrents that keep women away from antenatal care.
- ITN Misuse: By applying behavioral economics, we investigate alternative, non-intended uses of Insecticide-Treated Nets (ITNs), such as fishing or crop protection. We then develop and test targeted behavioral "nudge" interventions to increase proper nightly utilization within households.
- Care-Seeking Delays: We conduct rigorous gender analyses to identify the specific power dynamics and economic factors—such as lack of independent female income or transportation costs—that delay mothers from seeking Rapid Diagnostic Testing (RDT) for their febrile children within the critical 24-hour window.
2. Scaling Preventive Commodities
Generating research is only the first step; acting on it is where lives are saved. We support the "last-mile" delivery of essential malaria commodities by bypassing broken traditional supply chains and relying on localized, community-embedded distribution networks.
- ITN Distribution: We organize community-led distribution campaigns for Long-Lasting Insecticidal Nets (LLINs). By using local women leaders to distribute nets, we ensure they reach the most vulnerable targets—pregnant women and children under 5—while simultaneously providing culturally appropriate education on their setup and maintenance.
- SMC Support: We actively assist Ministries of Health in the rapid deployment of Seasonal Malaria Chemoprevention (SMC) during the high-transmission rainy seasons, ensuring that logistical bottlenecks do not prevent children from receiving their monthly preventative doses.
- The Malaria-MNCH Nexus: Recognizing that maternal health and malaria are deeply intertwined, our frontline workers aggressively drive demand for IPTp during routine ANC visits. We integrate malaria prevention seamlessly with maternal nutrition programs, offering a holistic package of care to expectant mothers.
MNCH Integrated Primary Care
Strengthening health systems from the ground up to drastically reduce maternal and neonatal mortality.
MNH Workforce & Clinical Capacity (EmONC)
The difference between life and death during childbirth often comes down to the split-second decisions and technical skills of a midwife. Recognizing this, our program completely overhauls traditional, theory-heavy training models. We are strengthening the frontline response through intensive, hands-on, high-fidelity simulation drills across 200+ target facilities. By replicating high-stress delivery scenarios, we build muscle memory and clinical confidence among healthcare providers.
- PPH Management: We train staff on the latest innovations in postpartum hemorrhage prevention, including the rapid deployment of uterine balloon tamponades and proper administration of uterotonics to stop bleeding—the leading cause of maternal death.
- Eclampsia Care: We drill standardized, rapid MgSO4 (Magnesium Sulfate) administration protocols to prevent and control life-threatening convulsions in pregnant women.
- Neonatal Resuscitation: Utilizing the 'Helping Babies Breathe' protocols, we ensure every delivery room has staff immediately capable of clearing airways and stimulating breathing in asphyxiated newborns.
- AI Diagnostics: We are pioneering the training of rural staff on emerging AI-powered diagnostic tools, allowing for early detection and monitoring of high-risk pregnancies even in the absence of specialist obstetricians.
Scaling Evidence-Based Medicines
Even the best-trained midwife cannot save a patient without the right tools. We are systematically scaling high-impact clinical innovations and fortifying supply chains to the last mile.
- Antenatal Corticosteroids (ACS): We are scaling the use of dexamethasone and betamethasone for women at imminent risk of preterm delivery. This crucial, low-cost intervention dramatically accelerates fetal lung maturation, exponentially improving the survival rate of premature babies.
- Multiple Micronutrient Supplements (MMS): We are leading the transition from basic iron-folic acid to comprehensive, high-quality prenatal vitamins (MMS) at scale to aggressively combat maternal anemia and significantly improve infant birth weights.
- Tracer Commodities: Through active, digitized cold chain monitoring, we maintain strict >95% availability of critical delivery drugs like Oxytocin and Misoprostol.
Facility Readiness & Enablers
A skilled provider needs a functional environment. We are building resilient infrastructure and strengthening vital health system enablers to support safe, dignified deliveries and efficient medical referrals.
- Inpatient Newborn Care: We are establishing dedicated newborn care units (INCUs) in rural hospitals, equipping them with reliable, piped oxygen and life-saving concentrators for premature and sick infants.
- Resilient Infrastructure: Recognizing that hygiene and power are non-negotiable, we are retrofitting facilities to ensure strict WASH (Water, Sanitation, and Hygiene) compliance and installing Solar Hybrid Power systems to prevent blackouts during night-time emergencies.
- Emergency Transport: We are optimizing community-to-facility triage flows and implementing robust, locally managed emergency transport networks to drastically reduce median referral times by up to 30%.
Digital Surveillance & Research
The Dònuèsè Data Center
In many Francophone African countries, health data is trapped on paper registers, resulting in weeks or months of delay before national decision-makers see a crisis unfolding. We are transforming surveillance into a predictive, real-time, actionable intervention. The Dònuèsè platform utilizes offline-capable mobile applications to bridge the critical gap between remote, disconnected rural clinics and centralized national tracking systems.
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Geospatial Tracking & Heatmaps: Community Health Workers log malaria cases, maternal complications, and treatments on tablets. This data syncs to create dynamic, predictive geospatial heatmaps that allow health ministries to anticipate and preempt transmission spikes or local outbreaks before they become epidemics.
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Stockout Alerts: Medical shortages kill. Dònuèsè features an automated 72-hour rapid response trigger. The moment a rural clinic reports a stockout of essential ACTs, RDTs, Oxytocin, or ACS, alerts are instantly routed to regional depots and RFLD logistics coordinators to mobilize emergency resupply.
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API-Driven DHIS2 Interoperability: To avoid creating parallel, fragmented systems, Dònuèsè is built to communicate directly with government servers. It seamlessly feeds localized demographic and epidemiological data directly into Ministry of Health DHIS2 systems, ensuring a single, unified source of truth for national planning.
Continuous Quality Improvement & Ground-Level Research
Data collection is meaningless without action. We aggressively institutionalize the PDSA Cycle (Plan-Do-Study-Act) for continuous, iterative problem-solving at the facility level. Instead of punitive reviews, we facilitate constructive, monthly maternal death and near-miss audits. By bringing together midwives, doctors, and community leaders to dissect exactly why a tragedy occurred, we transform systemic failures into actionable protocols, supported by joint MoH/RFLD supervision visits that foster accountability and mentorship.
Simultaneously, our operational research footprint is massive. Through our Biomarker Research Support, we utilize our vast community network to gather physiological and demographic data that helps global researchers identify early biomarkers predicting the risk of preterm birth and low birth weight in African populations. Concurrently, our continuous Barrier Mapping assesses the rollout and utilization of Inpatient Newborn Care units across diverse geographies. This real-world research generates practical, scalable learning resources, empowering policymakers to replicate successful care models across the continent.
Agile Financing & Advocacy
The WAFFF Mechanism: Bypassing Bottlenecks
One of the greatest tragedies in global health is the "missing middle" of finance. Massive global funds are allocated, but they frequently stall at the national government level due to bureaucracy, slow procurement, or political shifts. As a result, the critical funding fails to reach the frontline NGOs and civil society groups doing the actual, life-saving community distribution and education.
The Solution: RFLD utilizes the Women's Africa Feminist Fund (WAFFF) as an agile financial engine. We have opened a dedicated "Malaria & Gender" and MNCH thematic window to rapidly disburse cash grants directly to over 50 grassroots organizations. This allows local groups to execute highly contextualized, immediate health campaigns without waiting for state apparatuses.
Crucially, RFLD handles all the complex U.S. and international donor compliance, vetting, and auditing overhead. This ensures zero friction for the donors, 100% financial security, and guarantees that capital flows directly to where it impacts mortality rates the fastest.
Domestic Resource Mobilization
Foreign aid alone cannot sustain a continent's health system. For true, long-term sustainability, we must aggressively demand that African governments invest their own domestic budgets into health elimination and maternal care strategies. RFLD views policy advocacy not as a secondary activity, but as a core intervention.
- ✓ Legislative Tracking: We deploy our West Africa Legislative Platform to monitor and track national health budget allocations in real-time, holding governments accountable to their public promises.
- ✓ Grassroots Lobbying: We train our vast network of women leaders to actively lobby their local parliamentarians, demanding increased domestic funding for ITN procurement, ACT subsidies, and maternal care facilities.
- ✓ The Abuja Declaration: We mount relentless advocacy campaigns demanding strict state adherence to the Abuja Declaration, which mandates that governments allocate a minimum of 15% of their total national budget to the health sector.
The Praia Convention: Securing Political Will
We recognize that lasting health reform requires supreme political will. We will leverage the highly anticipated Francophone Feminist Leadership Convention in Praia as a premier political platform. By uniting civil society, health experts, and policymakers, our goal is to corner political leaders and secure binding, public financial commitments for Malaria and MNCH initiatives directly from attending ECOWAS heads of state and ministers of finance.
Projected Outcomes
👥 Community & Workforce Reach
The true scale of this program lies in its human capital. By activating an army of 156,000 Women Leaders alongside newly trained Male Health Activists, we are fundamentally rewriting the social fabric of health-seeking behaviors across the region. This massive workforce will act as the vanguard, reaching over 2 Million+ women and households directly at their doorsteps. They will provide vital education, dismantle toxic gender norms that prevent care access, and integrate Primary Health Care services into daily community life.
Simultaneously, the clinical backbone of the region will be fortified. By upskilling 800+ Midwives through intense, high-fidelity EmONC (Emergency Obstetric and Newborn Care) simulation drills, we are ensuring that when those 2 million households do seek care, they are met by highly competent, confident professionals capable of saving lives in the critical moments of childbirth.
🏥 Facility & Research Milestones
The physical infrastructure of healthcare in our target regions will undergo a massive resilience upgrade. Over 200+ Facilities will be retrofitted with solar power, strict WASH protocols, and fully functional Inpatient Newborn Care Units, ending the era of preventable neonatal deaths due to power outages or lack of basic oxygen.
On the systemic level, our supply chain interventions will ensure a revolutionary <5% Stockout Rate of tracer commodities like Oxytocin and ACTs, guaranteeing that the medicines are always there when needed. This logistical triumph, combined with community education, will drive a +25% Increase in ITN Utilization Rate. Finally, to ensure our learnings shape global policy, the program will yield 3 Major Operational Research Papers published in peer-reviewed journals, providing the global health community with unprecedented insights into overcoming behavioral barriers in Francophone Africa.
Partner With RFLD
Transforming health systems from the grassroots up across Francophone Africa.
Uncompromising Institutional Trust & Stewardship
In the landscape of international development, navigating bureaucratic compliance and financial risk often slows down life-saving work. RFLD is uniquely positioned to eliminate these hurdles. We serve as a secure, highly vetted bridge between major international philanthropic partners, donor agencies, and the vital grassroots organizations operating on the frontlines of the health crisis in Francophone Africa.
Our rigorous financial frameworks, transparent administrative standards, and deep local integration mean that every dollar invested is tracked, optimized, and impactful. We hold an NGOsource Equivalency Determination (ED), legally certifying us as equivalent to a U.S. 501(c)(3) public charity. This allows U.S.-based foundations to grant to us directly, without the friction or expense of expenditure responsibility (ER). Furthermore, our strategic operations in volatile regions, such as the Sahel, are protected by decentralized, low-profile logistics and offline-capable digital tracking, ensuring program continuity even in conflict zones.
✓ US 501(c)(3) Equivalent
NGOsource Certified, allowing seamless, frictionless direct grants from United States foundations and trusts.
✓ Diplomatic Standing
Official Observer Status with the African Commission on Human and Peoples' Rights (ACHPR) under the African Union.
✓ Financial Rigor
Commitment to total transparency with consecutive years of 100% clean external financial audits by leading firms.
✓ Unmatched Reach
Direct operational oversight of a thriving, mobilized network of over 450+ grassroots organizations across 8 nations.
Contact Our Leadership Team
AGUEH Dossi Sekonnou Gloria
Africa Director