DATA SANTÉ Mali

In Mali, more than 1000 health facilities, managed by Communitarian Health associations, faith-based and associative centers, medical and care offices, from the first level of the country’s healthcare system. Within a 15 kilometers radius, health facilities deliver individual and collective health care services, including curative, preventive, immunization, child growth follow-up and family planning services, to the 10 000 to 15 000 inhabitants of their health area. It is rare to see an individual patient file in a health facility in Mali, including for women (besides for the limited time of a pregnancy) and children. The information system of the health center is based on many paper-based registers in which are written every consultancy in chronological order. A register exists for curative care, another one for children immunization, another one for pregnancies follow-up, another for prescriptions, etc. The frequent lack of an individual patient file gathering information on all care services provided by different practitioners in the facility (doctors, midwives, matrons, nurses, health workers), makes it impossible to ensure a global medical follow-up of a patient. The parceling of cares impairs their quality, especially regarding women or children for whom curative and preventive cares, as well as follow-up activities (pregnancy, immunization) are also provided. The lack of an individual medical file doesn’t allow medical workers to analyze the health center’s activity, nor the creation or monitoring of care protocols and the search for an improvement in the quality of services provided to the population.

The DATASANTE MALI initiative intends to roll out an individual medical record for each patient in 27 health facilities in the Mopti, Ségou, Sikasso, Kayes and Koulikoro regions, through the use of Information and Communication Technologies. It’s a computerization project of the first level of care in Mali, which will improve the quality of patient management and of the provided healthcare, strengthen the team work in the facility, and enable the analysis of its activity (monthly records). This initiative intends more specifically to improve the medical follow-up of mothers and children under 5 in rural areas of the country (antenatal and postnatal visits, child’s development and growth, nutritional follow-up, immunization…), and of people living with chronic diseases. Santé Sud assures the technical and financial implementation of this project, as well as the monitoring activities. The 27 health facilities and their staff (general practitioners, midwives, nurses, etc.) are the target group, representing about 90 health professionals. The ultimate recipients of the initiative are the rural populations around the 27 health facilities, representing between 10 000 and 15 000 inhabitants per facility, that is about 162 500 inhabitants who would eventually come to the computerized health facility, especially men and women of child bearing age (56% of the targeted population), pregnant women (4%) and children under 5 (6%). The initiative DATASANTE MALI lies on several points:
– It develops a multi-users and multi-data entry system. The whole idea is to give an integrated professional computerization (only one patient record shared with all staff), linking preventive care and public health actions driven by midwives, nurses and health workers, in addition of curative care traditionally provided by doctors.
– It integrates communication tools via 3G Internet which make telemedicine experiences (diagnostic help, referencing, second opinion) and continuous training possible.
– It integrates gravity alerts (high-risk pregnancies, malnutrition), and diagnostic and prescription assistance tools.
– It allows the production of clinical and epidemiological data, and thus facilitates the development of monthly reports, which are sent to the medical district and are essential in the public health decision-making process.
– It intends to be gender-responsive by integrating gender components in its data repository and by producing data disaggregated by sex, in order to study women and children’ access to health care.
Expected results: The use of computer-based individual medical records in health facilities will enable the historical follow-up of patients. The collection, treatment and analysis of health-related data in those health areas will also be facilitated. The treatment of data will enable the head of the facility to better manage its health center, while the individual records will allow the provision of better healthcare services to patients, beyond the treatment of acute diseases. It will particularly allow the reduction of child and maternal mortalities by increasing the number of women getting antenatal visits, and of children under 5 following the immunization and nutritional calendars. Moreover, this initiative allows practitioners to have access to knowledge through continuous training tools and through facilitated communication with the medical community. Statistical reports developed by this project are used to evaluate its impact, and are shared to local and national health authorities to support the public health decision-making process in Mali.

The DATASANTE MALI initiative intends to improve the quality of health care provided in rural areas in Mali, by implementing a computerized (mobile and connected) system in health facilities, fostering team work around prevention and curative activities. This system of computerized individual health records is implemented in 27 health facilities directed by community general practitioners. This initiative enables rural and isolated populations, as well as health professionals working in those areas, to benefit from the use of new information and communication technologies applied to the health sector. The individual health record enables the personalized follow-up of each patient (diagnosis and treatments history, family planning, immunization, nutrition, chronic diseases and pregnancy follow-up…), with quantitative and qualitative data disaggregated by sex and age for women, men, children under five and persons living with chronic or serious diseases. An alert system inserted in the database enables health professionals to list and contact all patients who need a follow-up consultation. Disaggregating quantitative and qualitative data by age and sex allows studying women and children access to health services. The initiative also provides health professionals with diagnostic and prescription assistance, gravity alarms and continuing education tools. Sensitization and communication activities towards local communities, leaders, health professionals and traditional health providers intend to foster behavior changes in terms of nutritional care andreproductive health and to improve early access to health services.