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Patient involvement in care strategies for chronic diseases: the case of diabetes and HIV/AIDS care in Mali. What lessons can be learned?

par Martini, Jessica ;Tijou-Traoré, Annick;Dujardin, Bruno ;MAcq, Jean;Gobatto, Isabelle
Référence European congress on tropical medicine and international health (7: 3-6/10/2011: Barcelona), Tropical Medicine & International Health, Tropical Medicine & International Health (16), 3.5-005
Publication Publié, 2011-10-06

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Résumé :

The burden of chronic diseases dramatically increasing in developing countries, patient empowerment and patient-centred care are once again being promoted as key strategies for health system strengthening. In Sub-Saharan Africa, some progress has already been made in the field of HIV/AIDS, where patients are often involved in care management, but very few programmes have been developed for non-communicable chronic diseases so far. We focused on diabetes and HIV/AIDS in Mali. A literature review and interviews with national stakeholders and international donors were conducted to analyse national strategies for diabetes and HIV/AIDS, and to put into perspective the involvement of patients in the policy making process and care services. The case of Mali is very emblematic as the first mobilisation of diabetes patients dates back to 1991. But their empowerment has since been limited by the lack of national political support, of financial and material resources, and by the little international concern. For HIV/AIDS, the first mobilisation of patients at the beginning of the 1990s emerged in a context of “emergency” and relief care. Since HIV/AIDS has received close political attention, with the introduction of free antiretroviral drugs at the beginning of the 2000s, and donor funding has also increased. To date, the number of peer support programmes has multiplied, as has the number of patients’ associations and local NGOs. Analysing the evolution of diabetes and HIV/AIDS care raises the question of how does the chronicity of a disease influence patients’ empowerment. Also, the case of Mali clearly shows that patient mobilisation needs political leadership and international support to really succeed in influencing health policies and actively participating in care management. Lessons can be drawn on how to better involve patients in care and policy making and improve care for non-communicable chronic diseases.