[Neighbourhood rural medicine: an experience of rural doctors in Mali].
The main constraint to improving access to health services of quality in rural areas is to attract qualified health personnel in these areas. A fifteen years experience in rural health in Mali has shown that it is possible to develop community medicine practices in an African context that do integrate individual care and public health activities. The policy of decentralization of health services encouraged local communities and municipalities to recruit rural doctors themselves. An initiative of rural doctors materialized with this event as they founded a national association and adhere to the principles of a Charter to provide quality health care at an affordable cost. A mechanism of quality improvement was established with the participation of several partners: a professional association, a funding non-governmental organization, and groups of academic staff and health managers. This paper describes the evolution of the rural doctors' experience, its philosophy, conditions that made it successful, constraints it had to overcome and the attitude of partners. It highlights the potential of health care personnel in Africa to provide primary health care well beyond traditional programs on prevalent diseases and to respond to both urgent individual needs and pressing public health requirements.
Sante Sud, Bamako, Mali. santesud@afribone.net.ml
Seydou
S
Coulibaly
Dominique
D
Desplats
Yacouba
Y
Kone
Karamoko
K
Nimaga
Sylvie
S
Dugas
Guy
G
Farnarier
Mansour
M
Sy
Hubert
H
Balique
Ogobara K
OK
Doumbo
Monique
M
Van Dormael
D001291:Attitude of Health Personnel; D003153:Community Health Services / Q000458:organization & administration*; D003159:Community-Institutional Relations; D006801:Humans; D007400:Interprofessional Relations; D008302:Mali; D019982:Organizational Case Studies; D016730:Program Development / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods; D019035:Rural Health Services / Q000458:organization & administration*