Facteurs liés à l'instabilité des professionnels de soins au poste au Mali / Factors linked to the instability of care professionals at the post in Mali

La crise des ressources humaines en santé au Mali est marquée par une instabilité croissante du personnel de santé au poste. Elle constitue un obstacle majeur à l'atteinte des objectifs de développement durable et la couverture santé universelle. La formation continue reste un facteur de motivation du personnel et un moyen d'amélioration ou de maintien de la qualité des services. Mais elle semble àune influence sur la disponibilité des ressource humaines. Le but de l'étude est de mettre en exergue les liens entre l'instabilité des professionnels de soins au poste et les départs en formation continue diplômante. Nous avons mené une étude transversale, descriptive mixte dans différentes structures de santé du Mali. La population cible est composée des professionnels de santé en poste et les responsables de service. La collecte de données a été faite à travers des questionnaires et des entretiens semi structurés.Au niveau des résultats: 68% des agents ont terminé leur formation entre 2016-2017 contre 32% de 2013-2015. Pour la structure d'emplois, la majorité des agents enquêtés (54%) travaillent dans les CSRef. L'analyse des données recueillies met en évidence des irrégularités et insuffisances dans la mise en formation continue. Ces insuffisances sont liées à la0 planification, organisation et la gestion de la formation. La formation continue diplômante, bien que facteur de motivation, contribue à l'instabilité et insuffisance du personnel au poste au Mali.Mots clés: Formation continue diplômante; Instabilité;Mali;Professionnels de santé.

The health human resources crisis in Mali is characterized by the growing instability of health personnel in post. This represents a significant obstacle to the achievement of the objectives of sustainable development and universal health coverage. Training remains a motivating factor for health workers and is a means of improving or maintaining the quality of services. However, it has an influence on the availability of human resources. The objective of this study was to identify the relationship between the instability of healthcare professionals in the post and their participation in in-service training programs leading to a qualification. A cross-sectional, descriptive, mixed-methods study was conducted in various health facilities in Mali. The target population consisted of current healthcare professionals and department managers. Data were collected using questionnaires and semi-structured interviews. In terms of results: 68% of agents completed their training between 2016-2017 compared % in 2013-2015. For the employment structure, between 2016 surveyed (54%) work in CSRefs.The analysis of the data revealed irregularities and shortcomings in the implementation of continuing education. These shortcomings are linked to the planning, organization, and management of training. While in-service training leading to a qualification is a motivating factor, it contributes to the instability and inadequacy of the staff in post in Mali.

Oral Hygiene: Knowledge and Practices of Students in Three Quranic Schools in Koutiala, Mali

Objective: To evaluate the knowledge, attitudes, and practices on oral hygiene (OH) of students of three Quranic schools of Koutiala, Mali. Material and Methods: It was carried out a descriptive prospective study with 300 students in three Quranic schools in the city of Koutiala, Mali. The data analyzed with the Epi Info 3.5.4 software. Results: The male sex was the most represented with 57.7% and the sex ratio = 0.73. The most represented age group was 8-12 with 52% with an average age of 17 years and minimum and maximum age of was 8 and 26 years. It was observed that 98.3% of students had a notion of knowledge about oral hygiene and this information was given by parents / elders in 60% of cases. They claimed that people who do not brush their teeth properly are the most likely to get tooth decay in 93.3% of cases. Regarding dental caries, 61.3% of students said that caries is transmitted by lack of oral hygiene; 33.3% of students said that using toothbrushes and having good oral hygiene are ways to avoid oral diseases. It was thought in 93.3% of cases that a good oral hygiene prevents oral diseases. The students brushed their teeth every day (98%) and they had a consultation with the dental surgeon in 8.7% of the cases. Conclusion: This study shows that students had knowledge of oral hygiene and preventive measures. Efforts should be made to promote, prevent, screen and manage oral diseases in Quranic schools while involving parents in the processes.

Knowledge and Practical Attitudes of Surgeons-Dentists of Bamako District Facing the Septum Syndrome

Objective: To determine the knowledge and attitude of dental surgeons in Bamako regarding the management of septal syndromes. Material and Methods: It was a crosssectional and descriptive study conducted in the Bamako District, Mali. The following variables were collected: sociodemographic, training, knowledge of septal syndrome, therapeutic decisions and treatment. The data was collected from a survey sheet and processed by Epi-info Software version 3.5.3 and by the language R. Results: A total of 67 professionals participated in this study, of which 88.1% were men. Seventy-six point one percent of the Dental Surgeons have recognized septum syndrome as an emergency. The management of the emergency, followed by the completion of the comprehensive care later represents the attitude of 71.6% of the dentists. Sixty-four point two percent of dentists remove irritating elements under gingival, 80.6% prescribe an antiinflammatory, 38.8% prescribe chlorhexidine gel and 26.9% reconstruct the point of contact. Conclusion: This study demonstrates that Dental Surgeons in general have adequate average knowledge and attitude for their management of septal syndrome.

Knowledge, Attitudes and Practices of Doctors and Dental Surgeons in Bamako on the Relationship Between Periodontal Diseases and Chronic Non-Communicable Diseases

Objective: To assess the level of knowledge, attitudes and practices of doctors and dentists in Bamako on the relationship between chronic non-communicable diseases and periodontal diseases. Material and Methods: A cross-sectional study of 420 physicians and dental surgeons was conducted from March to August 2016. Data analysis involved descriptive statistics (frequency distribution). All statistical analyses were performed using the Epi Info 3.5.4 Software. Results: The male sex was the most represented with 58% for a sex ratio of 1.3. The most represented age group was 30-40 years old (48.8%) with an average age of 33 ± 8.2 years. General practitioners were the most represented in 93.6% of cases. Physicians with no knowledge of periodontal disease accounted for 60% of all cases, and all dental surgeons reported knowledge of chronic noncommunicable conditions in 100% of cases. Physicians and dental surgeons rated their knowledge levels of periodontal disease and chronic disease as inadequate in 98% and 90% of cases, respectively. Examination of the oral cavity by the doctors was "sometimes" carried out in 66% of the cases and the non-demand of the clinical signs of the gingival bleeding (64%) and dental migration (80.5%). They did not make recommendations on oral hygiene in 61.7% of cases. Conclusion: This study shows shortcomings among doctors and dentists in Bamako on the relationship between periodontal diseases and chronic non-communicable diseases. Capacity building and multidisciplinary collaboration are needed to support people's health.

Prevalence of Gingivitis among Malian Children

Objective: To determine the prevalence of gingivitis among Malian children in Bamako, Mali. Material and Methods: This cross-sectional study evaluated 2640 children aged between 3 to 14 years old and two examiners collected the data. The gingival index was used to determine the degree of gingival. Gingival inflammation has been classified localized and / or generalized according to site rate achieved. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: The prevalence of gingivitis was 87.5%. Regarding the distribution according to sex, the girls presented 60.6% while the boys 39.4%, with a sex ratio of 0.6. The most represented age group was 11-14 years old with 52.5% of cases. Plaque-induced gingivitis was the most common (58.2%), while moderate gingival inflammation affected 67% of the students with localized gingival inflammation involving 64.7% of the participants. Conclusion: The prevalence of gingivitis was high, so that early and correct management of this condition in children avoids complications and requires good oral hygiene.

Evaluation de la qualite de la prescription et de la dispensation des Combinaisons therapeutiques a base d'artemisinine (CTA) dans le district de Bamako; Mali

Entre avril et juillet 2008; nous avons mene une etude transversale sur la qualite de la prescription et de la dispensation des Combinaison Therapeutique a base d'Artemisinine (CTA) dans le traitement de l'acces palustre simple dans certains centres de sante et les officines ou depots de medicaments du district de Bamako. Au total; 52 prescripteurs; 72 dispensateurs et 90 patients ont ete inclus. L'etude a consiste a l'interview des sujets. L'enquete a revele que les CTA constituaient le traitement de premiere intention du paludisme chez les prescripteurs (75) et des dispensateurs (78;8). Cependant; 57;61des ordonnances contre le paludisme ne contenait pas de CTA. Les CTA recommandees par le programme national de lutte contre le paludisme (PNLP) etaient connues par 59;7des dispensateurs et 73;1des prescripteurs. La majorite des prescripteurs (71;15) et des dispensateurs (84;72) etaient favorables aux recommandations du PNLP. Beaucoup de patients (41;30) ne comprenaient pas du tout la posologie des CTA prescrites. Presque toutes les ordonnances contenant des CTA etaient prescrites en DCI (97;72; n = 44). Les prix des CTA ont varie entre 140 et 3 380 FCFA avec une moyenne de 750 FCFA. D'apres les reponses des prescripteurs et des dispensateurs; les CTA constituaient leur premier choix. Cependant; 57;61des ordonnances contre le paludisme ne contenait pas de CTA. La majorite des prescripteurs (71;15) et des dispensateurs (84;72) sont favorables aux recommandations du PNLP. Le cout moyen des ordonnances contenant les CTA etait 750 FCFA avec des extremes allant de 140 a 3680 FCFA. Une bonne utilisation des CTA s'avere imperative pour garantir leur efficacite et retarder voire eviter l'emergence de la resistance des parasites du paludisme a ces molecules