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Does the gap between health workers’expectations and the realities of implementing a performance-based financing project in Mali create frustration?

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Global Health Research and Policy 2021年第1期6卷 468-477页

作者： Tony Zitti Amandine Fillol Julia Lohmann Abdourahmane Coulibaly Valéry Ridde Centre Population et Développement(Ceped) Institut de recherche pour le développement(IRD)et Universitéde ParisInserm ERL 124445 rue des Saints-Pères75006 ParisFrance école doctorale pierre louis de santépublique Universitéde ParisParisFrance ONG Miseli BamakoMali Ecole de santépublique de l’Universitéde Montréal MontréalCanada London School of Hygiene&Tropical Medicine LondonUK Heidelberg Institute of Global Health Medical Faculty and University HospitalHeidelberg UniversityHeidelbergGermany Facultéde Médicine et d’Odontostomatologie Universitédes Sciencesdes Techniques et des TechnologiesBamakoMali

Background:Performance-Based Financing(PBF),an innovative health financing initiative,was recently implemented in *** aims to improve quality of care by motivating health *** purpose of this research was to identify and understand how health workers’expectations related to their experiences of the first cycle of payment of PBF subsidies,and how this experience affected their motivation and sentiments towards the *** pose the research question,“how does the process of PBF subsidies impact the motivation of health workers in Mali?”Methods:We adopted a qualitative approach using multiple case *** chose three district hospitals(DH 1,2 and 3)in three health districts(district 1,2 and 3)among the ten in the Koulikoro *** cases correspond to the three *** followed the principle of data source triangulation;we used 53 semi-directive interviews conducted with health workers(to follow the principle of saturuation),field notes,and documents relating to the distribution grids of subsidies for each *** analyzed data in a mixed deductive and inductive ***:The results show that the PBF subsidies led to health workers feeling more motivated to perform their tasks *** financial motivation,this was primarily due to PBF allowing them to work more ***,respondents perceived a discrepancy between the efforts made and the subsidies *** fact that their expectations were not met led to a sense of frustration and ***,the way in which the subsidies were distributed and the lack of transparency in the distribution process led to feelings of unfairness among the vast majority of *** results show that frustrations can build up in the early days of the ***:The PBF implementation in Mali left health workers *** short overall implementation period did not allow actors to adjust their initial expectations and motivational responses,neither positiv

关键词： Motivation of health workers Performance-based financing District hospital expectations Frustration Mali

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Antibacterial, Anti-Inflammatory and Antioxidant Activities of an ACAZY Herbal Formula Used in Traditional Medicine to Treat Respiratory Infections

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Natural Science 2024年第9期16卷 131-145页

作者： Mohamed Bonewendé Belemlilga Bagora Bayala Abdoul Gilchrist Laurent Boly Madinatou Annick Ouédraogo Alida Raissa Boina Boubacar Yaro Florentina Badea Camélia Diguti Moumouni Koala denise P. Ilboudo Charles Bavouma Sombié Pascal Nadembega Jean-Marie Compaoré Paul Darga Mahoukèdè Théodora Zohoncon Moussa Ouédraogo Aristide Traore Noufou Ouédraogo Florentina Matei Rasmane Semdé Sylvin Ouédraogo Jacques Simporé Innocent pierre Guissou Laboratoire de Recherche-Dveloppement de Phytomdicaments et Mdicaments (LR-D/PM) Institut de Recherche en Sciences de la Sant (IRSS) Centre National de la Recherche Scientifique et Technologique (CNRST) Ouagadougou Burkina Faso Centre de Recherche Biomolculaire Pietro Annigoni (CERBA) Ouagadougou Burkina Faso Laboratoire de Biologie Molculaire et de Gntique (LABIOGENE) Universit Joseph KI-ZERBO Ouagadougou Burkina Faso Ecole Normale Suprieure Koudougou Burkina Faso Laboratoire de Dveloppement du Mdicament (LADME) Centre de Formation de Recherche et dExpertises en Sciences du Mdicament (CEA-CFOREM) cole Doctorale Sciences de la Sant (ED2S) Universit Joseph KI-ZERBO Burkina Faso Laboratoire de Microbiologie Applique Universit des Sciences Agronomiques et de Mdecine Vtrinaire (UASMV) de Bucarest en Roumanie Bucharest Romania Dpartement de la mdecine traditionnelle Ministre de la Sant et de lHygine Publique Ouagadougou Burkina Faso Universit Saint Thomas dAquin (USTA) Ouagadougou Burkina Faso

ACAZY is a plant formula used in traditional medicine in Burkina Faso to treat respiratory infections. After phytochemical analysis, this study evaluated extracts’ anti-inflammatory, antioxidant and antibacterial properties from the ACAZY recipe. Three extractions, an aqueous macerate (AM), an aqueous decoction (AD) and an hydroethanolic macerate (HEM) of the ACAZY recipe powder were carried out. Phytochemical screening of the extracts was carried out using high-performance thin-layer chromatography (HPTLC) and the determination of phenolic compounds. The anti-inflammatory potential was assessed in vitro using pro-inflammatory enzyme inhibition tests. 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and Ferric-reducing antioxidant power (FRAP) antioxidant properties were also determined. The antibacterial activity was evaluated on Staphylococcus aureus and Streptococcus pneumoniae strains. Phytochemical analysis revealed the presence of flavonoids, saponins, tannins, anthracenosids, sterols and triterpenes in the extracts. The extracts inhibited pro-inflammatory enzymes by more than 40% at only 100 µg/mL. The extracts also showed potent antibacterial activity with a minimum inhibitory concentration 1 mg/mL on Staphylococcus aureus and 2 mg/mL on Streptococcus pneumoniae. The extracts in the ACAZY formula have shown anti-inflammatory and antioxidant properties in vitro. The AD also showed an antibacterial activity. This justifies its use in traditional medicine to treat acute respiratory infections.

关键词： ACAZY Anti-Inflammatory Antioxidant Antibacterial In Vitro

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