Towards Integrated People-centered Maternal, Newborn, and Child Health Care in Mali
The World Health Organization (WHO), through its Framework on integrated people-centred health services adopted by Member States in 2016, has called for a fundamental shift in the way health services are funded, managed, and delivered. Integrated people-centered health services (IPCHS) imply that the needs of people and communities, not diseases, should be put at the center of health systems. The approach seeks to empower people to take charge of their own health as a route to supporting improved health and wellbeing.
In Mali, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project has been working with the Ministry of Health since 2013 to contribute to reducing maternal, neonatal, and child mortality and morbidity. As part of ASSIST’s larger partnership with WHO to contribute to the development of IPCHS in different contexts and settings to promote learning, the project proposed to conduct a pilot project in Mali to assess the promotion of people-centered approaches in clinical consultations by health providers during pregnancy and delivery at peripheral health centers.
The project was implemented in five community health centers in the District of Diéma in Kayes Region beginning in March 2016. The objectives of the pilot project were to build capacity in the community to participate in the management of their own health issues; empower communities with knowledge and confidence in managing their health status; enable participation in decision-making with health providers so patients can shape decisions; and promote positive changes in health outcomes in households and communities. The people-centered care work was expanded to neighboring Yélimané District in Kayes in March 2017. The pilot activities were concluded in August 2017.
The core activity of the pilot project was to promote people-centered approaches in clinical consultations by health providers during pregnancy and delivery at peripheral health centers using the quality improvement (QI) approach of setting measurable objectives, testing at small scale changes in care delivery processes, and ongoing measurement of the results using predefined indicators. The pilot also sought to examine whether health providers are responsive to the needs and preferences of patients and to what extent patients and communities gained the support they needed to participate in the management of their own care.
WHO also collaborated with ASSIST on a similar assessment in South Africa.