TY - JOUR
T1 - Factors hindering health care delivery in nomadic communities
T2 - a cross-sectional study in Timbuktu, Mali
AU - Sangare, Moussa
AU - Coulibaly, Yaya Ibrahim
AU - Coulibaly, Siaka Yamoussa
AU - Dolo, Housseini
AU - Diabate, Abdoul Fatao
AU - Atsou, Kueshivi Midodji
AU - Souleymane, Abdoul Ag
AU - Rissa, Youssouf Ag
AU - Moussa, Dada Wallet
AU - Abdallah, Fadimata Wallet
AU - Dembele, Massitan
AU - Traore, Mahamadou
AU - Diarra, Tieman
AU - Brieger, William R.
AU - Traore, Sekou Fantamady
AU - Doumbia, Seydou
AU - Diop, Samba
N1 - Funding Information:
The study was supported by the UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) (No A90361) granted to YIC and the Faculty of Medicine and Odontostomatology of Bamako. Funders have no role in the study design, data collection, analysis and interpretation or the decision to write the manuscript.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - Access
KW - Delivery
KW - Healthcare
KW - Mali
KW - Nomadic
KW - Timbuktu
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UR - http://www.scopus.com/inward/citedby.url?scp=85101841686&partnerID=8YFLogxK
U2 - 10.1186/s12889-021-10481-w
DO - 10.1186/s12889-021-10481-w
M3 - Article
C2 - 33639923
AN - SCOPUS:85101841686
SN - 1471-2458
VL - 21
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 421
ER -