Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali.
BACKGROUND: Recently, a number of Global Health Initiatives (GHI) have been created to address single disease issues in low-income countries, such as poliomyelitis, trachoma, neonatal tetanus, etc. Empirical evidence on the effects of such GHIs on local health systems remains scarce. This paper expl...
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ftdoajarticles:oai:doaj.org/article:b00e64da552045cc9f8d645cedbfd9e1 2023-05-15T15:14:52+02:00 Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali. Anna Cavalli Sory I Bamba Mamadou N Traore Marleen Boelaert Youssouf Coulibaly Katja Polman Marjan Pirard Monique Van Dormael 2010-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000798 https://doaj.org/article/b00e64da552045cc9f8d645cedbfd9e1 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2923152?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000798 https://doaj.org/article/b00e64da552045cc9f8d645cedbfd9e1 PLoS Neglected Tropical Diseases, Vol 4, Iss 8, p e798 (2010) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2010 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000798 2022-12-31T06:24:42Z BACKGROUND: Recently, a number of Global Health Initiatives (GHI) have been created to address single disease issues in low-income countries, such as poliomyelitis, trachoma, neonatal tetanus, etc. Empirical evidence on the effects of such GHIs on local health systems remains scarce. This paper explores positive and negative effects of the Integrated Neglected Tropical Disease (NTD) Control Initiative, consisting in mass preventive chemotherapy for five targeted NTDs, on Mali's health system where it was first implemented in 2007. METHODS AND FINDINGS: Campaign processes and interactions with the health system were assessed through participant observation in two rural districts (8 health centres each). Information was complemented by interviews with key informants, website search and literature review. Preliminary results were validated during feedback sessions with Malian authorities from national, regional and district levels. We present positive and negative effects of the NTD campaign on the health system using the WHO framework of analysis based on six interrelated elements: health service delivery, health workforce, health information system, drug procurement system, financing and governance. At point of delivery, campaign-related workload severely interfered with routine care delivery which was cut down or totally interrupted during the campaign, as nurses were absent from their health centre for campaign-related activities. Only 2 of the 16 health centres, characterized by a qualified, stable and motivated workforce, were able to keep routine services running and to use the campaign as an opportunity for quality improvement. Increased workload was compensated by allowances, which significantly improved staff income, but also contributed to divert attention away from core routine activities. While the campaign increased the availability of NTD drugs at country level, parallel systems for drug supply and evaluation requested extra efforts burdening local health systems. The campaign budget barely financed ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 4 8 e798 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Anna Cavalli Sory I Bamba Mamadou N Traore Marleen Boelaert Youssouf Coulibaly Katja Polman Marjan Pirard Monique Van Dormael Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali. |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: Recently, a number of Global Health Initiatives (GHI) have been created to address single disease issues in low-income countries, such as poliomyelitis, trachoma, neonatal tetanus, etc. Empirical evidence on the effects of such GHIs on local health systems remains scarce. This paper explores positive and negative effects of the Integrated Neglected Tropical Disease (NTD) Control Initiative, consisting in mass preventive chemotherapy for five targeted NTDs, on Mali's health system where it was first implemented in 2007. METHODS AND FINDINGS: Campaign processes and interactions with the health system were assessed through participant observation in two rural districts (8 health centres each). Information was complemented by interviews with key informants, website search and literature review. Preliminary results were validated during feedback sessions with Malian authorities from national, regional and district levels. We present positive and negative effects of the NTD campaign on the health system using the WHO framework of analysis based on six interrelated elements: health service delivery, health workforce, health information system, drug procurement system, financing and governance. At point of delivery, campaign-related workload severely interfered with routine care delivery which was cut down or totally interrupted during the campaign, as nurses were absent from their health centre for campaign-related activities. Only 2 of the 16 health centres, characterized by a qualified, stable and motivated workforce, were able to keep routine services running and to use the campaign as an opportunity for quality improvement. Increased workload was compensated by allowances, which significantly improved staff income, but also contributed to divert attention away from core routine activities. While the campaign increased the availability of NTD drugs at country level, parallel systems for drug supply and evaluation requested extra efforts burdening local health systems. The campaign budget barely financed ... |
format |
Article in Journal/Newspaper |
author |
Anna Cavalli Sory I Bamba Mamadou N Traore Marleen Boelaert Youssouf Coulibaly Katja Polman Marjan Pirard Monique Van Dormael |
author_facet |
Anna Cavalli Sory I Bamba Mamadou N Traore Marleen Boelaert Youssouf Coulibaly Katja Polman Marjan Pirard Monique Van Dormael |
author_sort |
Anna Cavalli |
title |
Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali. |
title_short |
Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali. |
title_full |
Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali. |
title_fullStr |
Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali. |
title_full_unstemmed |
Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali. |
title_sort |
interactions between global health initiatives and country health systems: the case of a neglected tropical diseases control program in mali. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2010 |
url |
https://doi.org/10.1371/journal.pntd.0000798 https://doaj.org/article/b00e64da552045cc9f8d645cedbfd9e1 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 4, Iss 8, p e798 (2010) |
op_relation |
http://europepmc.org/articles/PMC2923152?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000798 https://doaj.org/article/b00e64da552045cc9f8d645cedbfd9e1 |
op_doi |
https://doi.org/10.1371/journal.pntd.0000798 |
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PLoS Neglected Tropical Diseases |
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e798 |
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