Private Health Sector Assessment in Mali : The Post-Bamako Initiative Reality[Étude sur le secteur privé de la santé au Mali : La situation après l’initiative de Bamako]

This country assessment of the private health sector in Mali is part of a series of studies designed to deepen understanding of ways to enhance the health policy framework, business environment, and investment climate in which the private health sector operates in African countries. The Malian health system has evolved dramatically since the middle of the 1980s. A large part of the analysis in this report relies on the reprocessing and the mining of existing databases, the financial and macroeconomic models based on those data, and elements reconstructed through triangulation. Those calculations proved indispensable for assessing the main demographic trends in the private sector, for estimating the growth of community centers (CSCOMs) and private mutual insurance, and identifying how to reinforce them. The growth of the private sector is further held back by insufficient educational preparation for practice in the private sector and in rural areas. For-profit and not-for-profit health care providers, pharmacies, and schools should be given beefier access to funding during start-up. Other financial engineering strategies (participation, etc.) could also be devised. The government of Mali has an opportunity to take advantage the large and dynamic private health sector in contributing to its national health care objectives and outcomes. The study describes the various instruments of stewardship towards the private sector that could be used such as information, regulations, financing and direct provision of public services in areas of significant market failure.