Community management of handpumps has been the accepted mode of thinking for rural water supply over three decades in Africa. However, despite billions invested in rural handpumps one in three handpumps do not work in rural Africa. This represents a huge wasted investment and is associated with high but avoidable health, welfare and livelihood costs. Encouragingly, the risk of handpump breakdown bears all the hallmarks of an insurable risk.
This project conducts a randomized controlled trial of two health care policies in a peri-urban region of Bamako, Mali: the provision of free primary care, and regular visits from health workers who teach mothers good practices and accompany children to the doctor.