The government in Mali has embarked on an ambitious effort to sustainably strengthen its health systems, aiming to improve the health of its citizens and establish a health sector that’s resilient to shocks (such as an economic downturn or global pandemic). A new collaboration to undertake this work includes U.S. funding support and technical expertise from a global consortium of health policy and supply chain experts.

Palladium leads a team of experts, including FHI 360, Groupe Pivot Santé Population (GPSP), and i+solutions. This is the first time that Palladium has joined with i+solutions as a major partner on a USAID health systems strengthening and service delivery project. i+solutions has global experience in providing methods and tools for the management of the supply chain of health products, serving organisations such as USAID, UNICEF, and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Addressing Healthcare Challenges

There have been significant improvements in some health outcomes over the past two decades in Mali, including a broad national decentralisation strategy that puts health services and health facilities under the “ownership” of local leadership. Nevertheless, challenges remain in how to plan, manage, and finance high-quality healthcare at a decentralised level. Local government, the private sector, and civil society are increasingly important to the collaborative solving of problems across systems, data use, quality of care, and supply chains.

To help address these challenges, USAID has awarded this Palladium-led team a USD 45 million cooperative agreement: Mali Health Systems Strengthening, Governance, and Financing Activity (HSS).

“We will apply an integrated, community-based approach that addresses bottlenecks in systems strengthening,” says Ron MacInnis, a Director in Palladium’s Health practice.

Strengthening Systems in Key Regions

HSS is a five-year (2020-2025) project to support health systems strengthening in areas of Mali that account for approximately half the country’s population: the regions of Mopti, Ségou, and Sikasso.

In Mali, FHI 360 will lead the service delivery, quality improvement, and laboratory strengthening components of the project, including specific functions at community and district levels, such as supervision, referral systems, outreach services, and community oversight. FHI 360 is a trusted partner of the Ministry of Health and Social Affairs in Mali and implements multiple health and governance activities in the regions targeted by HSS.

i+solutions will lead rationalising the supply chain to the last mile. GPSP has a network of more than 250 nongovernmental organisation (NGO) partners. GPSP will mobilise communities and build local NGO capacity, utilising its presence in the three regions.

“Palladium and its partners will work with regional, district, and local stakeholders from government, civil society, and the private sector,” notes Roland Kone, the Chief of Party for the new project. “The focus will be to improve governance of local health facilities, financial management of health facilities, health insurance coverage, quality of health services, commodity distribution, and health data collection and use.”

Applying Expertise

Palladium will apply its experience in Mali from the Health Policy Plus and Keneya Jemu Kan projects. Additionally, Palladium draws on decades of supply chain logistics experience across the globe, particularly with the Australian and UK governments.

“We’ve proudly had a role in Mali’s progress to improved health outcomes,” says Katrena Henderson, Senior Director of Health at Palladium. “We’re honoured to be able to continue supporting the Ministry of Health and Social Affairs on the journey to self-reliance and resiliency.”

It’s clear that a holistic strategy will be required, as the ministry addresses persistent challenges to stewardship of the health sector – ranging from poor coordination across government levels to inadequate resources for health facilities.

“Imagine the challenges and possibilities,” says Kone. “Just take one aspect, the supply chain. We’ll explore innovations in getting essential medicines, vaccines, and reproductive health commodities to health facilities and the communities they serve, especially those at the last mile.”

“The new distribution arrangement will benefit both the availability of donor-funded products and products sold through cost recovery mechanisms,” explains Per Kronslev, Senior Supply Chain Consultant with i+solutions. “We’ll also move the financial management of clinics’ procurement to a digital format, securing the choice of quality suppliers.”

”The results of HSS will contribute to achieving higher-level health system outcomes,” says Kone, “such as financial protection, provision of quality essential services, population coverage, and responsiveness of the health system in Mali.”

The HSS team:

Palladium will provide technical leadership in governance, health information systems, health financing, private sector engagement, and human resources for health.

FHI 360 will be responsible for technical leadership and incorporation of high-impact approaches for service delivery and quality improvement.

Groupe Pivot Santé Population will implement direct localised programs on community mobilisation, community-led monitoring, local governance and accountability, and NGO capacity strengthening.

i+solutions will provide innovative global solutions to supply chain management, rationalising the information flow and improving the distribution of health products.