Factors hindering health care delivery in nomadic communities: a cross-sectional study in Timbuktu, Mali

BMC Public Health

William R. Brieger¹  Massitan Dembele²  Mahamadou Traore²  Fadimata Wallet Abdallah³  Abdoul Fatao Diabate³  Samba Diop³  Sekou Fantamady Traore³  Housseini Dolo³  Siaka Yamoussa Coulibaly³  Dada Wallet Moussa³  Kueshivi Midodji Atsou³  Seydou Doumbia³  Yaya Ibrahim Coulibaly³  Youssouf Ag Rissa³  Abdoul Ag Souleymane³  Moussa Sangare⁴  Tieman Diarra⁵ 

[1] Department of International Health, Health System Program, The Johns Hopkins Bloomberg School of Public Health, 21205, Baltimore, MD, USA;General Directorate of Health and Public Hygiene, Ministry of Health and Social Affairs of Mali, Bamako, Mali;Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali;Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali;Interdisciplinary School of Health Sciences

[2]  Faculty of Health Sciences, University of Ottawa, 75, av. Laurier Est, Ottawa ON K1N 6N5, Canada;World Health Organization (WHO), Regional Office for Africa, PO Box 06, Cite du Djoue, Brazzaville, Congo;

关键词: Nomadic;    Access;    Healthcare;    Delivery;    Timbuktu;    Mali;   

DOI  :  10.1186/s12889-021-10481-w

来源: Springer

【 摘 要 】

BackgroundIn Mali, nomadic populations are spread over one third of the territory. Their lifestyle, characterized by constant mobility, excludes them from, or at best places them at the edge of, health delivery services. This study aimed to describe nomadic populations’ characteristics, determine their perception on the current health services, and identify issues associated with community-based health interventions.MethodsTo develop a better health policy and strategic approaches adapted to nomadic populations, we conducted a cross-sectional study in the region of Timbuktu to describe the difficulties in accessing health services. The study consisted in administering questionnaires to community members in the communes of Ber and Gossi, in the Timbuktu region, to understand their perceptions of health services delivery in their settings.ResultsWe interviewed 520 individuals, all members of the nomadic communities of the two study communes. Their median age was 38 years old with extremes ranging from 18 to 86 years old. Their main activities were livestock breeding (27%), housekeeping (26.4%), local trading (11%), farming (6%) and artisans (5.5%). The average distance to the local health center was 40.94 km and 23.19 km respectively in Gossi and Ber. In terms of barriers to access to health care, participants complained mainly about the transportation options (79.4%), the quality of provided services (39.2%) and the high cost of available health services (35.7%). Additionally, more than a quarter of our participants stated that they would not allow themselves to be examined by a health care worker of the opposite gender.ConclusionThis study shows that nomadic populations do not have access to community-based health interventions. A number of factors were revealed to be important barriers per these communities’ perception including the quality of services, poverty, lifestyle, gender and current health policy strategies in the region. To be successful, future interventions should take these factors into account by adapting policies and methods.

【 授权许可】

CC BY