ABSTRACT
La crise des ressources humaines en santé au Mali est marquée par une instabilité croissante du personnel de santé au poste. Elle constitue un obstacle majeur à l'atteinte des objectifs de développement durable et la couverture santé universelle. La formation continue reste un facteur de motivation du personnel et un moyen d'amélioration ou de maintien de la qualité des services. Mais elle semble àune influence sur la disponibilité des ressource humaines. Le but de l'étude est de mettre en exergue les liens entre l'instabilité des professionnels de soins au poste et les départs en formation continue diplômante. Nous avons mené une étude transversale, descriptive mixte dans différentes structures de santé du Mali. La population cible est composée des professionnels de santé en poste et les responsables de service. La collecte de données a été faite à travers des questionnaires et des entretiens semi structurés.Au niveau des résultats: 68% des agents ont terminé leur formation entre 2016-2017 contre 32% de 2013-2015. Pour la structure d'emplois, la majorité des agents enquêtés (54%) travaillent dans les CSRef. L'analyse des données recueillies met en évidence des irrégularités et insuffisances dans la mise en formation continue. Ces insuffisances sont liées à la0 planification, organisation et la gestion de la formation. La formation continue diplômante, bien que facteur de motivation, contribue à l'instabilité et insuffisance du personnel au poste au Mali.Mots clés: Formation continue diplômante; Instabilité;Mali;Professionnels de santé.
The health human resources crisis in Mali is characterized by the growing instability of health personnel in post. This represents a significant obstacle to the achievement of the objectives of sustainable development and universal health coverage. Training remains a motivating factor for health workers and is a means of improving or maintaining the quality of services. However, it has an influence on the availability of human resources. The objective of this study was to identify the relationship between the instability of healthcare professionals in the post and their participation in in-service training programs leading to a qualification. A cross-sectional, descriptive, mixed-methods study was conducted in various health facilities in Mali. The target population consisted of current healthcare professionals and department managers. Data were collected using questionnaires and semi-structured interviews. In terms of results: 68% of agents completed their training between 2016-2017 compared % in 2013-2015. For the employment structure, between 2016 surveyed (54%) work in CSRefs.The analysis of the data revealed irregularities and shortcomings in the implementation of continuing education. These shortcomings are linked to the planning, organization, and management of training. While in-service training leading to a qualification is a motivating factor, it contributes to the instability and inadequacy of the staff in post in Mali.
ABSTRACT
BACKGROUND: Midwives' contribution to improving outcomes for women and newborns depends on factors such as quality of pre-service training, access to continuing professional development, and the presence of an enabling work environment. The absence of opportunities for career development increases the likelihood that health professionals, including midwives, will consider leaving the profession due to a lack of incentives to sustain and increase motivation to remain in the field. It also limits the opportunities to better contribute to policy, training, and research. This study aimed to assess the influence of a Master in Sexual and Reproductive Health (SRH) at the INFSS on midwives' career progression in Mali. METHODS: This mixed methods study was conducted using an online questionnaire, semi-structured interviews, and a document review. The study participants included graduates from two cohorts (N = 22) as well as employers, managers, and teachers of the graduates (N = 20). Data were analysed according to research questions, comparing, and contrasting answers between different groups of respondents. RESULTS: The study revealed that graduates enrolled in the programme primarily to improve their knowledge and skills in management and public health. The graduates' expected roles are those of programme and health project manager and participation in planning and monitoring activities at national or sub-national level. The managers expected the programme to reflect the needs of the health system and equip midwives with skills in management and planning. The Master enhanced opportunities for graduates to advance their career in fields they are not usually working in such as management, research, and supervision. However, the recognition of the master's degree and of the graduates' profile is not yet fully effective. CONCLUSION: The master's degree in SRH is a capacity building programme. Graduates developed skills and acquired advanced knowledge in research and management, as well as a postgraduate degree. However, the master programme needs to be better aligned with health system needs to increase the recognition of graduates' skills and have a more positive impact on graduates' careers.
Subject(s)
Midwifery , Infant, Newborn , Humans , Female , Pregnancy , Mali , Reproductive Health , Education, Graduate , Public Health/educationABSTRACT
West Africa is engaged in a process of harmonising health workers' training programmes as a means to regulate regional training standards and thus improve their quality. There is currently a lack of documented information regarding the adoption of these revised training programmes. In 2012 a harmonised programme, the WAHO competency-based curriculum, was introduced in Mali for training midwives. The present study explores the barriers and facilitators of the adoption of this programme and how the content, context, process, and actor-related factors influenced this. We used a qualitative research design consisting of document analysis (n = 25) and semi-structured interviews (n = 21) with policymakers, students, and those in charge of implementing the training programme. Information was collected on education and training policies, the context and process of the harmonised curriculum development, its adoption, and the actors involved in the adoption strategy, along with their role. The study shows that the adoption of the harmonised curriculum in Mali offered midwives an opportunity to attain a higher standard of training and level of qualification than before. It also displayed both the government's and the public school's willingness and commitment to improve maternal and child health through enhancing midwives' training standards. The most salient factors that influenced adoption were the lack of available resources, and the lack of involvement of, and coordination with, relevant actors for successful policy adoption. Mali's experience of adopting the harmonisation policy of training curricula demonstrates the need for the authorities to collaborate with relevant actors for information dissemination and in the adoption process. It also demonstrates the need for finding innovative ways to secure and diversify funding opportunities, as well as establish a supervisory body for health worker training.
ABSTRACT
OBJECTIVE: To assess iodine status and its determinants in women of childbearing age in a rural area in the Kayes region, Mali, West Africa. DESIGN: Cross-sectional study where women's iodine status was indicated by urinary iodine concentration (UIC) and level of goitre based on palpation. Salt iodine was assessed semi-quantitatively at household level. Individual characteristics were collected using questionnaires. SETTING: Fifteen villages in a rural area in the Kayes region of Mali. SUBJECTS: Women aged 15-45 years (n=423). RESULTS: Median UIC was 2.7 microg dl(-1), and only 6% of the women had adequate iodine status of UIC >10 microg dl(-1). Most women (60%) had visible goitre, and only 9% were classified as without goitre. Only 39% of the households were using salt with any iodine, and level of knowledge about salt iodisation was low. Main determinants of UIC were breast-feeding and level of salt iodisation; currently breast-feeding women had lower UIC, and UIC increased with increasing level of iodine in household salt. Prevalence of goitre was lower in older women with higher body mass index. CONCLUSION: The study indicates severe iodine deficiency in the study area. Urgent action is needed to improve the situation through enforcing salt iodisation legislation and increasing the level of knowledge about the importance of iodised salt in the population.
