Strengthen capacities at policy and health system level, Mali

Objectives

In Mali 20.9% of the people over 15 are inactive, 21% of the people over 20 are overweight (25.7% among women) and 5.7% are obese.
The Malian health system has been radically modified in its capacity to cope with the prevention and the care of diabetes over the past decade. Diabetes has now been included in training of nurses contributing to the spread of the education and the care for diabetes all over Mali. During the last years, Mali has implemented an ambitious social protection policy through the development of the Compulsory Medical Aid system for health coverage of the population. Diabetes care is therefore now to be covered by this system and reimbursed at approximately 80% /100%).

Objectives
To reinforce national strategies dedicated to the fight against diabetes and related NCDs and co-infections and to reinforce the health system for the care of diabetes.

Approach

This project will adopt an institutional, operational and administrative approach. In order to strengthen the position of diabetes in the health system in Mali, Santé Diabète will ensure that all policy documents linked to NCDs, nutrition, maternal and infantile health, TB, HIV are reinforced and include diabetes.

Santé Diabète will advocate for the development and the implementation of a diabetes-related national health policy in Mali. To cope with this stronger and more favourable policy environment and with the need of the population for more decentralised access to care, Santé Diabète will substantially increase the number of health care professionals trained on diabetes, including on pregnancy and diabetes, at the various level of the health pyramid and in addition also include training for HIV and TB.

The administrative environment will through this project be reinforced by including diabetes in the upcoming Universal Health Coverage system in Mali and through the computerisation of medical files.

At the end of the project, Mali will have a tailor-made, efficient and sustainable political environment, adequate administrative support and a dedicated, decentralised and reinforced system of care for diabetes.

People with diabetes will benefit from accessible quality care everywhere in the country leading to better prevention and management of diabetes and a decrease in the number of severe complications and premature deaths.

To ensure efficacy and long-term sustainability, all the main health stakeholders in Mali will be involved from the start of the project: Ministry of Health, National and Regional Health Directorates, National, Regional hospitals and health structures; specialist doctors (diabetes, TB and HIV) and health care professionals, patients and patient associations (diabetes, HIV and TB) and Santé Diabète.

Results at completion

Political and strategic frameworks have been strengthened allowing greater involvement of the state and the development of stronger strategies:

New NCD policy validated technically and adopted politically with a sub-strategy on diabetes.
Development of advocacy tools and documents for inclusion of diabetes in the UHC incl. advocacy to include diabetes care and treatment in UHC.
Strengthening of other policy documents incl. development of technical documents on Diabetes / HIV & Diabetes / TB.
WDD celebrations conducted
The data-hub and the DT1 app developed. Feedback and capitalization of data to improve data management in the Ministry conducted.
32 diabetes consultation strengthened and now manage more than 20,000 patients.
16 students obtained 4-year endocrinology diploma and 20 students obtained diploma in diabetology.
The number of specialists in endocrinology has increased allowing the Malian state to deploy these at decentralized level.
The doctors and nurses are trained in new districts to increase the number of diabetes consultation:

619 health professionals from primary and secondary structures were trained on the detection and management of uncomplicated diabetes but also on the detection and management of gestational diabetes.
178 health professionals (diabetes focal points, HIV focal points and TB focal points) were trained in the management of diabetes / HIV and diabetes / TB comorbidities
The rebuild of diabetes consultation in the northern regions of Mali conducted