Assessment of Health System and Prevalence of Diabetes in the Bamako-Mali
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Abstract
Context: The demographic growth of the city of Bamako estimated at 5.4% (RGPH 2009) is higher than the national average (3.4%). The outlook for the period 2006-2020 shows that Bamako will experience the strongest annual growth of all African agglomerations. By 2025, more than 3 million inhabitants will reside in Bamako. This growth is accompanied by environmental changes leading to changes in people's lifestyles, especially food. The consequences can be the rise of obesity, overweight and diabetes which begins to weigh on the Malian health system. Objective: Analyse the health offer and the prevalence of diabetes in public and private health services, such as community health centers (CSCOM), reference health centers (CSREF), hospitals and clinics in Bamako. Methods: Retrospective cross-sectional study focused on data from January to December 2019 with 30 health structures which were (04 Hospitals; 06 CSREF; 12 CSCOM; 06 Private clinics and 02 denominational clinics. Results: Of the 30 structures surveyed, 8 were from the private sector (26.67%) and 22 from the public sector (73.33%). Diabetes screening was effective in all structures. Diabetes screening and management were effective in 13 of the 30 facilities. 12 of these structures were from the public sector and one from the private sector. We also found that 10/12 were CSRefs and hospitals. The management of diabetes in CSRef and hospitals were assured at least by an endocrinologist and / or a diabetologist in 76.92% (13 structures and 18 specialists). There was no presence of specialists in the private sector and in the CSCom. The active file of diabetic patients was estimated at 16,574 patients in the 30 structures. Conclusion: This research made possible the identification of diabetes management process in Bamako. The research clearly identify the existing gaps between the different structures but also the multiple underlying constraints. This study could facilitate the planning of capacity building actions and the technical platform of health structures. It allows, to overcome some of the difficulties raised, to amplify the impact of the actions targeted on the optimization of the management of diabetes in Mali.
