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Sangare M, Coulibaly YI, Coulibaly SY, Dolo H, Diabate AF, Atsou KM, Souleymane AA, Rissa YA, Moussa DW, Abdallah FW, Dembele M, Traore M, Diarra T, Brieger WR, Traore SF, Doumbia S, Diop S. Factors hindering health care delivery in nomadic communities: a cross-sectional study in Timbuktu, Mali. BMC Public Health 2021; 21:421. [PMID: 33639923 PMCID: PMC7916290 DOI: 10.1186/s12889-021-10481-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 02/22/2021] [Indexed: 11/21/2022] Open
Abstract
Background In 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. Methods To 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. Results We 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. Conclusion This 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. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10481-w.
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Affiliation(s)
- Moussa Sangare
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali. .,Interdisciplinary School of Health Sciences
- Faculty of Health Sciences, University of Ottawa, 75, av. Laurier Est, Ottawa ON K1N 6N5, Canada.
| | - Yaya Ibrahim Coulibaly
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Siaka Yamoussa Coulibaly
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Housseini Dolo
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdoul Fatao Diabate
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Kueshivi Midodji Atsou
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdoul Ag Souleymane
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Youssouf Ag Rissa
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Dada Wallet Moussa
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Fadimata Wallet Abdallah
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Massitan Dembele
- General Directorate of Health and Public Hygiene, Ministry of Health and Social Affairs of Mali, Bamako, Mali
| | - Mahamadou Traore
- General Directorate of Health and Public Hygiene, Ministry of Health and Social Affairs of Mali, Bamako, Mali
| | - Tieman Diarra
- World Health Organization (WHO), Regional Office for Africa, Cite du Djoue, PO Box 06, Brazzaville, Congo
| | - William R Brieger
- Department of International Health, Health System Program, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Sekou Fantamady Traore
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Seydou Doumbia
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Samba Diop
- Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
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