Proactive Community Case Managment and Child Survival: A Cluster-Randomized Controlled Trial

Investigator: Ari Johnson, MD
Sponsor: Muso, Inc

Location(s): Mali


Proactive Community Case Management, uses a simple idea: time matters. The main diseases that kill children worldwide progress rapidly. Children living in poverty are more likely to die because they get care too late. To fix this, Mali’s solution flips traditional healthcare on its head: health care providers, instead of waiting passively for their patients, go out door-to-door, searching for sick children.

“Last year 5.9 million children died before their fifth birthday. This is an enormous injustice that we must end together. As a global community, we have all the tools we need to end this crisis now. If we can reach children early with care, in the first hours of their illness, this global crisis will grind to a halt and millions of lives could be saved,” said Dr. Ari Johnson, CEO of Muso and Assistant Professor at the University of California San Francisco.

The Pro-CCM Muso model, which has been highlighted as a global best practice, will assist the Malian Ministry of Health in its five-year strategic plan to scale-up CHWs nationally. Muso’s proactive health system includes three core elements: 1) Community Health Workers search proactively for patients door-to-door 2) CHWs provide Doorstep Care to treat simple but deadly diseases in the home, and 3) Rapid-Access Clinics provide care quickly  and proactively to patients with more complex or advanced illness. At CGI, Muso and the Ministry of Health committed to testing this proactive healthcare model at scale, serving 250,000 people across nine sites in Mali. Along with this scale-up, a randomized controlled trial will measure the impact of proactive care on universal health coverage and child survival.

Muso is a global health organization working in Mali. We believe that every person has the right to access health care, and we are committed to designing innovative health care systems to make that right a reality. Our mission is to eliminate preventable deaths in the world’s most vulnerable communities. After having demonstrated success in our current area of intervention, we are planning to replicate our innovative health care system in rural Mali and then take our model to scale. For more information about Muso’s work, please visit


At the United Nations General Assembly (September 2019) in New York, the Minister of Health of Côte d’Ivoire and the nongovernmental organization Muso jointly signed a memorandum of understanding for a technical assistance partnership. This partnership will focus on high-impact community health interventions and their implementation throughout the nation of 24 million. 

Muso will bring its expertise in community health systems design and dedicated supervision to this new scope of work in Côte d’Ivoire and will work to ensure both fidelity and adequate adaption to the needs of diverse communities across Côte d’Ivoire. An important step for the new partnership will be deploying research-based strategies at the national scale.