E-Health Activities Reference Centre - Mali

This project, E-health activities reference centre in Mali follows the pilot experience on the projects REIMICOM and teleradiology IKON, which consisted for REIMICOM in setting up a health information portal for health practitioners and the general public, offering a few telemedicine tools to health practitioners and interconnecting about ten health institutions. For IKON, it consisted in enabling the exchange of X-ray images between the regional hospitals of Timbuktu, Mopti, Segou and Sikasso with the university hospital of Point G in Bamako. At the end of the first phase, the REIMICOM objectives were partially reached. The health portal was technically set up but regular content production remained a problem. About six institutions were interconnected. Regarding telemedicine tools, an E-learning and E-consultation platform was made available to the health practitioners.  Using those tools is still experimental or demonstrative in most health institutions. For IKON, the project demonstrated a real interest at the level of regional hospitals in the use of teleradiology (particularly in the far away or isolated regions). It also demonstrated that technically, no big investments were needed. However, the integration of the service in the daily administrative functioning of hospitals is still to be realised.

In addition, several initiatives were developed in parallel, independently from each other. The E-health (telemedicine-E-health) activities Reference Centre will be a tool to unite many Information and Communication Technology (ICT) for Health projects in Mali. The centre will enable telemedecine and E-health services to be effectively operational on the ground and put them at the disposal of health practitioners and the general public.  

The study of the Mali social and health development decennial Plan from 1998 to 2008 shows that progress has been made. Thus, life expectancy grew from 56,9 years in 1987 to 58,5 years in 1994. The child death rate regressed by 22%, and juvenile death by 30%. Leprosies, tuberculosis, onchocercosis which evolved on an endemic mode regressed. The creation of several health structures enabled the coverage of several illnesses, from the first step of the health system.

However, according to the same document health indicators figures remain preoccupying :

• The child death rate is 122,5 °/00
• only 42% of the population has access to drinking water
•  6% of the population live under the poverty limit
•  The mother death rate amounts to 577 for 100,000 births

Health personnel is poorly spread between the capital and the other regions, and between the urban and rural zones. More than half of the socio-sanitary staff of Mali is concentrated in Bamako: 57% of the doctors, 41% of the nurses and 64% of the midwives (MSSPAS, 1998).

The health system counts with a pyramidal organization, which goes from the periphery to the centre: it goes from the central level of community health (villages and communes), passing through the health reference centre (health district, circle), the regional and secondary hospitals (regional level), to the tertiary and university hospitals (national level). It is characterised by a shortage of specialists, which are all concentrated in the capital city. The demand for specialised healthcare of the population is significantly increasing. The time needed to get a specialised consultation is getting longer. Access to a good interpretation of complementary exams (X-rays, echography, cytology…) is rather difficult, even in regional capital cities. University expertise is only available in Bamako.

Read more about IICD's Mali Country Programme.

The project implementation started in April 2007 under the name CNRAES. The project was temporarily halted in October 2007 due to organisational difficulties.  After internal measures were taken, the project was allowed to restart under a new name - CERTES, in May 2008.

Operationalise a National Reference Centre for Telemedicine and E-Health activities in Mali. The centre’s main objective will be to coordinate national E-Health activities on the technical and organisational level and to establish international relations.

Offer an expertise and exchange platform to all Health service related actors who want to experiment telemedicine or other E-Health activities.  

Specific objectives are:

• Develop telemedicine and other E-Health activities based upon the expertise acquired by the REIMICOM executing staff

• Set up a real time control centre for E-Health activities at the level of the Bamako based hospital Mother- Child

• Develop action research on the most adapted tools for E-Health in the Malian context

• Test, develop and/or experiment with software for telemedicine and E-Health

• Develop and offer E-services related to Health emergencies via the Health portal for Mali

• Develop local content related to E-Health

• Sensitize Health authorities, Health staff and the wider public in Mali on the potential of E-Health for the Health system in Mali

• Promote synergy between all existing telemedicine and E-Health activities in Mali

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Reseau Informatique Malien d'Information et de Communication Medicale (Reimicom) is a non-governmental organisation with the mission to enhance the use of ICT in health in Mali.