La résilience de l’hôpital du Mali face à la COVID-19 dans un contexte de pénuries

Coulibaly, Abdourahmane; Touré, Laurence; Zinszer, Kate; Ridde, Valéry

doi:10.3917/spub.216.0935

Cited by 4 publications

(6 citation statements)

References 27 publications

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“…This measure has led to profound changes in the care platform in the local health system, resulting in the creation of a “new” district hospital, with a substantially reduced technical platform. In Mali, buildings were also requisitioned to cope with the multiple effects of COVID-19 ( 16 ). In Ethiopia, some health facilities that provide TB care and treatment services were transformed into COVID-19 isolation and treatment centers ( 17 ) like in Benin.…”

Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 pandemic on provision and use of maternal health services in Allada, southern Benin: a local health system perspective

Akpi,

Vigan,

Boyi Hounsou

et al. 2023

Front. Public Health

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ObjectiveTo assess the effects of the COVID-19 pandemic on the provision and use of maternal health services in southern Benin from a local health system perspective.MethodsWe conducted a qualitative study from April to December 2021 in a health district in southern Benin. We interviewed health workers involved in antenatal, delivery, postnatal and family planning care provision, alternative and spiritual care providers, administrative staff of the district hospital, community health workers, adolescents and women who had given birth in the past six weeks in public health centers were interviewed. The World Health Organization health systems building blocks framework was used to guide the thematic analysis from a local health system perspective.ResultsThe COVID-19 pandemic changed the lines of command and the institutional arrangements in the local health systems leadership; it put the interpersonal relationships in the health care provision team under stress and reduced the overall revenues of the district hospital. The motivation of allopathic health workers was undermined. Communities underutilized maternal health services in the COVID-19 period. Plausible causes included negative patient perceptions of COVID-19 measures taken at the public health facility level as well as well as fear of being forcibly vaccinated against COVID-19 in the health facilities.ConclusionIn times of health crises, appropriate local health system governance that integrates providers’ concerns into effective guidelines is critical to reach and maintain a sufficient level of work motivation to ensure quality maternal health services.

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Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 pandemic on provision and use of maternal health services in Allada, southern Benin: a local health system perspective

Akpi,

Vigan,

Boyi Hounsou

et al. 2023

Front. Public Health

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“…Yet, at the heart of the quality of care44 and their deficiencies were a ‘ fatal hypothesis for the project ’40 according to the capitalisation report. In addition to the two coups d’état during the project period (and France’s decision at the beginning of 2022 to suspend its collaboration with Mali), the COVID-19 pandemic and its impacts on the Malian health system are obviously part of the explanation,45 46 especially since 1.2 million Euros of the I3S project were allocated to the fight against this pandemic. While CBHI innovation has been relatively well accepted, significant challenges of coordination of the actors involved and coherence with State policies have been identified 47.…”

Section: Implementation Challengesmentioning

confidence: 99%

Improving healthcare accessibility for pregnant women and children in the context of health system strengthening initiatives and terrorist attacks in Central Mali: a controlled interrupted time series analysis

Zombré,

Diarra,

Touré

et al. 2024

BMJ Glob Health

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IntroductionThe Health and Social Development Program of the Mopti Region (PADSS2) project, launched in Mali’s Mopti region, targeted Universal Health Coverage (UHC). The project addressed demand-side barriers by offering an additional subsidy to household contributions, complementing existing State support (component 1). Component 2 focused on supply-side improvements, enhancing quality and coverage. Component 3 strengthened central and decentralised capacity for planning, supervision and UHC reflection, integrating gender mainstreaming. The study assessed the impact of the project on maternal and child healthcare use and explored how rising terrorist activities might affect these health outcomes.MethodsThe impact of the intervention on assisted births, prenatal care and curative consultations for children under 5 was analysed from January 2016 to December 2021. This was done using an interrupted time series analysis, incorporating a comparison group and spline regression.ResultsC1 increased assisted deliveries by 0.39% (95% CI 0.20 to 0.58] and C2 by 1.52% (95% CI 1.36 to 1.68). C1-enhanced first and fourth antenatal visits by 1.37% (95% CI 1.28 to 1.47) and 2.07% (95% CI 1.86 to 2.28), respectively, while C2 decreased them by 0.53% and 1.16% (95% CI −1.34 to −0.99). For child visits under 5, C1 and C2 showed increases of 0.32% (95% CI 0.20 to 0.43) and 1.36% (95% CI 1.27 to 1.46), respectively. In areas with terrorist attacks, child visits decreased significantly by 24.69% to 39.86% compared with unexposed areas.ConclusionThe intervention had a limited impact on maternal and child health, falling short of expectations for a health system initiative. Understanding the varied effects of terrorism on healthcare is key to devising strategies that protect the most vulnerable in the system.

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“… 3 In most contexts, it seemed that once the first wave of pandemic and the first drastic public health measures passed, the use of care and the functioning of health facilities returned to normal. 4 5 This was the case for family planning in Senegal. 6 …”

Section: Introductionmentioning

confidence: 99%

“…At the global and African level, several studies have been carried out to understand the resilience of health systems and in the context of the COVID-19 pandemic, 8 15 including in the Sahel. 4 5 However, access to care concerns not only supply but also demand for care. 16 Some studies have shown that the demand for care has been reduced in the context of the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

“…The Africa Centres for Disease Control and Prevention predicted that the continent’s health systems were well prepared 3. In most contexts, it seemed that once the first wave of pandemic and the first drastic public health measures passed, the use of care and the functioning of health facilities returned to normal 4 5. This was the case for family planning in Senegal 6…”

Section: Introductionmentioning

confidence: 99%

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The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

Ridde

Kane

Mbow³

et al. 2022

BMJ Glob Health

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BackgroundIn its pursuit of solutions for universal health coverage (UHC), Senegal has set up two departmental health insurance units (UDAMs) since 2014. Few studies on the resilience of health systems in Africa have examined health insurance organisations. This article aims to understand how these two UDAMs have been resilient during the COVID-19 pandemic and the restrictive measures imposed by the State to maintain services to their members and reimbursements to healthcare providers.MethodsThis study was a multicase study with multiple levels of analysis using a conceptual framework of resilience and analysis of organisational configurations. Empirical data are derived from document analysis, observations for 6 months and 17 qualitative in-depth interviews.ResultsThe results identified three main configurations concerning (1) safety and hygiene, (2) organisation and planning and (3) communication for sustainable payment. The UDAM faced the pandemic with resilience processes to absorb the shock and maintain service to their members. The UDAM learnt positive lessons from crisis management, such as remote work or the ability to support members in their care in hospitals away from their headquarters. They have innovated (transformative resilience) with the organisation of electronic payment and the use of social networks to raise funds and communicate with members. Strengthening their effectiveness after the shock of the departure of the donors in 2017 contributed to the adaptation and even transformation from the pandemic shock of 2020 and 2021. The study shows that leadership, team dynamics and adaptation to contexts are drivers of resilience processes.ConclusionBoth UDAMs adapted to the shocks of the pandemic and government measures to maintain the services of their members and their organisational routine. This resilience confirms that UDAMs are one of the possible solutions for UHC in the Sahel.

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La résilience de l’hôpital du Mali face à la COVID-19 dans un contexte de pénuries

Cited by 4 publications

References 27 publications

Effects of COVID-19 pandemic on provision and use of maternal health services in Allada, southern Benin: a local health system perspective

Effects of COVID-19 pandemic on provision and use of maternal health services in Allada, southern Benin: a local health system perspective

Improving healthcare accessibility for pregnant women and children in the context of health system strengthening initiatives and terrorist attacks in Central Mali: a controlled interrupted time series analysis

The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

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