Mali case management

Health system

Central:

  • 5 public hospitals, research institutes, mother-child hospital: research

Region:

  • 8 public hospitals: treat severe cases with complications

Operational:

  • 65 First referral health centers (RHCs): treat severe cases of malaria

Villages and hamlets:

  • 2,437 community sites: integrated essential community health care
  • 2015: 1,204 functional community health centers (Centres de Santé Communautaire [CSCOM])
  • Community health volunteers: IEC/BCC activities
  • Parastatal, faith-based, military, and other private health centers also found in  community

 

Stock:

Mali is currently transitioning from quinine to injectable artesunate. 2017 and 2018: Mali has a large supply of injectable artesunate at the central medical warehouse, and there will be concurrent use of injectable quinine until supplies are used up.

  • Health centers typically use whatever severe malaria medication is available in a severe malaria emergency.

 

Access:

  • 43% of the population has access to health care services within a 5km radius of the health care facilities
  • Special kits are supplied to health establishments for the free treatment of severe malaria among children under 5 and pregnant women. This free service does not include the consultation and treatment fees.

 

Challenges to treatment

  • Accessibility to health center
  • Management of medical products (supply, filling out of data formats)
  • Management of data (promptness, completeness, quality control);
  • Quality assurance system;
  • Human resources, especially at the operational level;
  • Classification of malaria cases into uncomplicated and severe cases;
  • Apparent use of injectable drugs to treat certain uncomplicated cases;
  • Training and supervision of health workers
  • Incentives to health workers
  • Working conditions

 

Funding:

  • The state is contributing up to 50% of requirements for the treatment of severe malaria cases (health care facility level)
  • PMI is providing the remainder