Health Needs Assessment for the City of Segou, Mali - Millennium ...

Annex C: Standards of Healthcare Services by MDG Priority in Ségou City
Child Health
(Pediatrics)
Maternal
and
Reproductive
Health
Malaria
Primary Services (CSCOM) Secondary Services (CSREF) Tertiary Services (Hospital)
Local bacterial infections,
uncomplicated dehydration,
uncomplicated malnutrition /
underweight, uncomplicated
anemia, coughs/colds, pneumonia,
uncomplicated (non-measles)
fever, uncomplicated measles, all
immunizations
Short-term family planning,
prenatal care, including IPT for
malaria, skilled labor assistance,
postnatal care, PMTCT
ITMs, preventive prophylaxis,
IPT for pregnant women,
uncomplicated malaria
Severe bacterial infections, severe
dehydration, dysentery, severe
malnutrition, severe anemia,
severe pneumonia, sepsis,
meningitis, severe febrile disease,
urinary tract infections, eye
infections, mouth ulcers,
mastidoitis, chronic or acute ear
infections, ophtalmia neonatorum
Long-term family planning,
urinary tract infection, mastitis,
STDs
Rapid diagnostic testing (RDT),
Severe or complicated malaria
Tuberculosis DOTS+ therapy TB laboratory tests
HIV/AIDS
Voluntary counseling and testing
(VCT), PMTCT, antiretroviral
(ARV
) prescription and monitoring,
STD and OI care, psychosocial
support, adherence education,
minimal laboratory activities
(hemoglobin and hematocrit
levels, HIV and TB screening)
Exams (viral charge, creatine,
bacteriology, parasitology,
hematology)
Very severe pneumonia, effusion
and pleura effusion and empyema,
severe asthma, viral croup,
diphtheria, pertussis, heart failure,
typhoid fever, septic arthritis,
dengue hemorrhagic fever
Obstructed labor, forceps or
vacuum-assisted delivery,
Cesarean sections, postpartum
hemorrhage, maternal puerperal
sepsis, hypertension (preeclampsia
and eclampsia), postabortion
complications 29
, fistula,
complicated referral cases
Severe or complicated malaria
requiring a blood transfusion
Special consultations and exams,
CD4 counts, support for labwork,
determining pharmacological
dosage, tests for first-line drug
resistance
29 Abortion is illegal throughout Mali. However, abortions are routinely carried out in private clinics, and many
pregnancies are self-terminated by overdosing on contraception medication. Women will arrive at the health facility
denying knowledge of a pregnancy and of having taken such medications. An obstetrician-gynecologist reported
that nearly one in four Malian women will terminate a pregnancy in this manner over the course of their
reproductive years. Furthermore, when a woman dies due to post-abortion complications, the autopsy is
immediately classified as a hemorrhage, so as to protect the family. The official data recorded regarding abortion
remains very limited, due to legal constraints and the informality and/or the private circumstances under which the
procedure ordinarily takes place.
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