Integration of basic dermatological care into primary health care services in Mali.
OBJECTIVE
To evaluate, in a developing country, the effect of a short training programme for general health care workers on the management of common skin diseases--a neglected component of primary health care in such regions.


METHODS
We provided a one-day training programme on the management of the skin diseases to 400 health care workers who worked in primary health care centres in the Bamako area. We evaluated their knowledge and practice before and after training.


RESULTS
Before training, knowledge about skin diseases often was poor and practice inadequate. We found a marked improvement in both parameters after training. We analysed the registers of primary health care centres and found that the proportion of patients who presented with skin diseases who benefited from a clear diagnosis and appropriate treatment increased from 42% before the training to 81% after; this was associated with a 25% reduction in prescription costs. Improved levels of knowledge and practice persisted for up to 18 months after training.


CONCLUSIONS
The training programme markedly improved the basic dermatological abilities of the health care workers targeted. Specific training may be a reasonable solution to a neglected component of primary health care in many developing countries.
Mahé
Antoine
A
Department of Dermatology, Institut d'Hygiène Sociale, Dakar, Senegal. mahe@refer.sn
Faye
Ousmane
O
N'Diaye
Hawa Thiam
HT
Konaré
Habibatou Diawara
HD
Coulibaly
Ibrahima
I
Kéita
Somita
S
Traoré
Abdel Kader
AK
Hay
Roderick J
RJ
D002983:Clinical Competence; D003151:Community Health Centers / Q000592:standards*; D019033:Delivery of Health Care, Integrated; D003880:Dermatology / Q000193:education*; D003906:Developing Countries; D004502:Education, Medical, Continuing; D019317:Evidence-Based Medicine / Q000193:education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008302:Mali; D011320:Primary Health Care / Q000592:standards*; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012871:Skin Diseases / Q000628:therapy*