Mali

The intermittent administration of seasonal malaria chemoprevention (SMC) is recommended to prevent malaria among children aged 3–59 months in areas of the Sahel subregion in Africa. However, the cost-effectiveness and cost savings of SMC have not previously been evaluated in large-scale studies. We did a cost-effectiveness and cost-savings analysis of a large-scale, multi-country SMC campaign with sulfadoxine–pyrimethamine plus amodiaquine for children younger than 5 years in seven countries in the Sahel subregion (Burkina Faso, Chad, Guinea, Mali, Niger, Nigeria, and The Gambia) in 2016. The total cost of SMC for all seven countries was $22·8 million, and the weighted average economic cost of administering four monthly SMC cycles was $3·63 per child (ranging from $2·71 in Niger to $8·20 in The Gambia). Based on 80% modelled effectiveness of SMC, the incremental economic cost per malaria case averted ranged from $2·91 in Niger to $30·73 in The Gambia. The estimated total economic cost savings to the health systems in all seven countries were US$66·0 million and the total net economic cost savings were US$43·2 million. Our interpretation is that SMC is a low-cost and highly cost-effective intervention that contributes to substantial cost savings by reducing malaria diagnostic and treatment costs among children.

The world is facing an unprecedented crisis related to the COVID-19 pandemic with many unknowns, which has led to much confusion and anxiety. Public health measures have for centuries been the cornerstone of the response to epidemics. Among them, physical distancing measures aim to reduce contact between infected and uninfected people. As part of the global COVID-19 response, they have been widely used to slow down the spread of the virus in several countries. Despite their overall acceptance, they have been poorly documented, particularly in Africa, and debates persist on their appropriateness and practicality in the context of low-income countries. This article describes the implementation of these measures in four West-African countries—Mali, Burkina Faso, Senegal and Guinea—and discusses people’s willingness to comply with them. We describe these measures and discuss the importance of considering the socio-cultural, economic and political context to choose the most appropriate and effective measures and propose ways to explore strategies that are potentially better adapted to the African context.

The objective of this study was to describe the conceptual and implementation approach of selected digital health technologies that were tailored in various resource-constrained countries. Drawing from our multi-year institutional experience in more than 20 high disease-burden countries that aspire to meet the 2030 United Nations Sustainable Development Goal 3, we screened internal project documentation on various digital health tools that provide clarity in the conceptual and implementation approach. Taking into account geographic diversity, we provide a descriptive review of five selected case studies from Bangladesh (Asia), Mali (Francophone Africa), Uganda (East Africa), Mozambique (Lusophone Africa), and Namibia (Southern Africa). A key lesson learned is to harness and build on existing governance structures. The use of data for decision-making at all levels needs to be cultivated and sustained through multi-stakeholder partnerships. The next phase of information management development is to build systems for triangulation of data from patients, commodities, geomapping, and other parameters of the pharmaceutical system. A well-defined research agenda must be developed to determine the effectiveness of the country- and regional-level dashboards as an early warning system to mitigate stock-outs and wastage of medicines and commodities.

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