The role of non-governmental organizations in strengthening healthcare systems in low- and middle-income countries: Lessons from Santé Diabète in Mali

Figures & data

Table 1. Level and number of interviews carried out in 2018 and total interviews in 2004

	2018									Total 2004
	Bamako	Gao	Kayes	Koulikoro	Mopti	Segou	Sikasso	Timbuktu	Total
Level: Macro (Ministry of Health, Central Medical Stores, NGOs, Civil Society, Ministry of Finance, Private sector)	10								10	20
Level: Meso (Regional Health Authorities, Regional Medical Stores, health facilities, private clinics, laboratories, pharmacies)	25	6	6	9	6	11	15	5	83	47
Level: Micro (health professionals, traditional healers and people with diabetes)	94	19	18	28	29	29	45	16	269	83
Total	129	25	24	37	26	40	60	21	362	150

Table 2. Strengths and weaknesses of different insurance schemes in Mali relative to diabetes

Insurance scheme	Strengths	Weaknesses
AMO	Large number of public and private facilities included (health facilities and pharmacies) 70% coverage on insulin and oral medicines	Only for formal sector (less than 20% of Malian population) Blood glucose meters and strips not included
AMV	Large number of public and private facilities included (only pharmacies) 75% coverage of medicines included on Malian essential medicine list (Metformin, Glibenclamide and Insulin)	Lack of awareness of this scheme High cost of monthly premium (FCFA 575 (US$ 1.03)) Blood glucose meters and strips not included Other oral diabetes medicines are not included
RAMED	100% coverage of medicines included on Malian essential medicine list	Lack of awareness of scheme Assessment of need obscure and length bureaucratic process Blood glucose meters and strips not included Other oral diabetes medicines are not included

Figure 1. Government procurement and patient public and private prices for a vial (10 ml 100IU) insulin (2018 US$).

Figure 2. Summary of health system support or strengthening activities and role SD played in this.

Health system support (shown in red) versus strengthening (in green). Areas falling in-between health system support and health system strengthening (shown in orange)