Devolution activities in Mali

WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTE ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA PRoGRAMME DE LUTTE CONTRE L',ONCHOCERCOSE EN AFRIQUE DE L',OUEST NATIONAL ONCHOCERCIASIS COMMITTEES NOCl5.7 ORIGINAL: FRENCHFifteenth meeting Ouasadoueou. 28-30 Mav l99l National 0NCE0 Co-ordinator MALI I - Devolution A national devolution plan has been prepared since then. It has so far not received any financing (external support). A request is being prepared. However, in the mean time, an effort has been made by the government by the inclusion of a budget line in the national budget to support activities related to onchocerciasis control that the national team could undertake. In concrete terms, the following have been carried out: - establishment of a passive ivermectin treatment network in the seven (7) district health centres in the Sikasso region - idem in the three (3) districts in the Koulikoro region (Dioila, Kangaba, Kati) - monitoring of these different centres - integration of these activities into the regional and local plans - taking into account of the National Devolution Plan in the different regi6nal health programmes. Example: Mopti - trial of integration of onchocerciasis into other health programmes currently being carried out. Though not in real devolution phase, many actions have been taken in the same direction in the national structures in the western extension. II - Health Education - Actions taken A l99l oncho information plan of action has been prepared and submitted to OCP. It will be implemented this year within this framework: - material preparation made (official letter, contacts, ...) with a view to a televised oncho interview + show and film-show followed by discussion on oncho and the Programme in schools and certain oncho villages. Criteria for selection of these villages: - situated in hyperendemique zone; - situated in zone where there are socioeconomic development activities; e.g. Baguineda - eventually, subjected to active ivermectin treatment - good accessibility. 2This concerns Mali's western extension. It will extended to the initial area in accordance with our l99l plan (see annual report 1990). OCP support will be necessary for the implementation of the oncho information plan of action. III - Ivermectin distribution The following have been carried out: - active distribution in the hyperendemic zones of the river basins of the Niger, Bakoye, Baoule, Faleme. They are undertaken under EPI/OCP TSAs. They have been several visits to each river basin. - passive distribution: - 93 passive ivermectin distribution centres have been operational since 1990 - 27,306 tablets have been distributed by these centres - I 1,700 persons have been treated: The delayed reports which have reached us will enable us correct these figures. An intensification is being prepared. Difficulties met: - shortage of scales - shortage of report forms in the differents centres - accessibility difficulties. Absence of mopeds in the district health centres or bad state if there are some, fuel, etc.. - motivation of field personnel: allowance, etc.. - irregularity of supply of monthly forms due to above-mentioned difficulties. IY - Inventorv The following have been gathered: - documents on inventory of public and private health centres in the onchocerciasis zones (western extension + devolution zone) - inventory of personnel - - inventory of logistics for some health centres has been sent to us However, inventories of medical and technical equipment are not yet available because they are more difficult to get.