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MSF in Mali, 2006/2007
Field Staff: 69
Reason for Intervention:
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In July 2005, MSF launched a project to help people with malaria in Kangaba, in southern Mali. A medical investigation conducted by MSF in 2004 had shown that, in addition to significant mortality rates, there were high levels of resistance to the chloroquine-based therapies used for treatment. Despite the government’s implementation of a more effective artemisinin combination therapy (ACT ) policy for malaria in 2004, quantities of these drugs were insufficient and too expensive for widespread use.
To support the implementation of this new treatment, MSF focused its efforts on seven community health centers and the reference health center in Kangaba. The use of ACT in tandem with a rapid screening test (RST) has provided a technical response to the treatment of malaria and chloroquine resistance, where 7,784 people were treated for malaria through this project in 2006. Yet the project still faced two major problems: quality of care and access to the treatment.
Beginning in December 2006, MSF made these issues top priorities. At seven health centers in Kangaba, MSF succeeded in obtaining free healthcare (including malaria diagnosis and treatment) for children under five years of age, as well as free care for pregnant women suffering from malaria. A flat rate policy was also implemented at three health centers in December 2006 for the care of febrile diseases (malaria and others), to replace the cost-recovery system; as of July 2007, this policy was in force at the seven health centers. Finally, additional human resources have been made available to oversee and improve the quality of diagnosis and care. Since July 2007, MSF has implemented a strategy for the free treatment of malaria by community groups equipped with the RST and ACT, for children under the age of ten, at sites located more than five kilometers from the health center.
In northern Mali, in the regions of Gao, Kidal and Timbuktu, MSF in 2006/2007 responded to high rates of maternal mortality by developing a program to care for pregnant women and their babies. After taking over obstetric-related surgical interventions, improving infrastructures and providing maternal health training to health groups and the population, MSF withdrew from the project in January 2007, handing it over to health authorities.
MSF has worked in Mali since 1992.