Private Health Sector Assessment in Mali
7
An Extensive Territorial Network
By mid-2009, the network of about 900 CSCOMs covered almost 90 percent of health areas defined in Malian sectoral policy. Outside of Bamako, 87 percent of the population is located within 15 km of a CSCOM and 51 percent within 5 km. To date, 90 percent of the catchment areas (1,070 in all) have a CSCOM, whose rate of creation accelerated since the end of the 1990s (figure 2.1). Figure 2.1. Evolution of CSCOM Accessibility 80 69%
58%
Percent
60 46%
50%
47%
80%
79%
76%
75%
71%
58%
51%
40
20
0
2003
2004
2005
2006 2007 2008 Accessibility rate within a 5 km radius Accessibility rate within a 15 km radius
Sources: Statistical Directory 2009; health map—Bilan C files 2008 DNS CPS; interviews, BCG analysis. Note: Data for Bamako are excluded from this analysis.
This fast progression results from the deliberate policy to improve rural dwellers’ geographical accessibility to health services (figure 2.2). It is a significant success for public policy. Some CSCOMs, however, have opened although they do not meet viability criteria, in particular in terms of population pool.
Figure 2.2. Population within 15 km of a CSCOM (percent)
Private Medicine
Nearly half of all physicians in Mali have their main practice in the private sector. Because the public sector cannot employ all newly graduated
% of the population within 15 km radius 60-70% 70-80% 80-90% More than 90%
Sources: Bilan C files; BCG analysis. Note: CSCOM excluding Gao.