. Everyday vulnerabilities and "social dispositions" in the Malian Sahel, an indication for evaluating future adaptability to water crises?. Regional Environmental Change, Springer Verlag, 2015, 16 (5) Abstract Since the 1970s, precipitation in the Sahel has decreased and become very irregular, leading to widespread drought, whilst the human need for water has rapidly increased. A new ''dispositions''-based approach was adapted in order to analyse human interactions with environmental hazards and applied to the case of Hombori village in north-eastern Mali. This article explores how the population and political stakeholders perceive, live with and respond to the increasing scarcity of water. It also explores how their current vulnerability and ability to cope with variations in available water resources indicate future adaptability to climate shocks. On the one hand, this research shows how the population copes with variations in water resource availability: the population's socio-spatial organisation explains the inhabitants' exposure to this problem and some of the factors affecting vulnerability, the elderly and women being the hardest hit. The water issue is generally managed on a ''day-to-day'' basis and considered a big problem only in the dry season, thus lowering any incentive for self-protection. The main two variables that could explain this kind of risk management are the conflicting local governance and current social rules. On the other hand, the discussion of results, based on a conceptual model of social responses, explains why these current ''social dispositions'' to cope with and even address the water scarcity issue do not guarantee future adaptability to climate change.

L’article propose une réflexion sur le processus d’émergence de la politique environnementale malienne en réponse aux grandes sécheresses depuis les années 1970. Celles-ci ont certes mis à l’agenda politique les interdépendances entre la dégradation des processus environnementaux et celle des dynamiques sociales et économiques du pays (PNAE/PAN-CID, 1998). Mais si elles ont sans doute généré une prise de conscience de l’ampleur et de la complexité des problèmes à traiter, elles n’expliquent pas, à elles seules, les transformations de l’action publique dans ce domaine au Mali. Nous montrons en effet que les ruptures politiques à partir de mars 1991 (accès à la démocratie, multipartisme, décentralisation) ont créé une fenêtre d’opportunités réunissant les conditions propices à l’élaboration concertée de la politique environnementale du pays.

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Acute respiratory infections (ARI) are a major public health issue in Mali. The objective of this study was to examine the management of ARI within the community among children aged 2 to 59 months. The study was based on a pilot community intervention over a period of 15 months (June 2008-August 2009) in 4 health districts in Mali. A survey was conducted two weeks before the intervention in order to determine the incidence of ARI. During the intervention phase, 80 community health workers (CHW) and 1,123 mothers were trained, equipped and supervised. 3,532 children aged 2 to 59 months were managed. Two health areas were selected in each district. A "CHW" area (i.e. an area where CHWs were trained and supervised) and a "mother" area (i.e. an area where mothers were trained and supervised) were randomly selected. Among the managed ARI cases, there were more cases of pneumonia in the "mother" areas (29.5%) than in the "CHW" areas (24.9%) (p = 0.003). The study also found that the duration of the prescription period was more appropriate in "CHW" areas (99.5%) than in "mother" areas (97.6%) (p = 0.03). In addition, the reduction in the incidence of complicated cases (before and after intervention) was more significant in "mother" areas (from 69? to 6?, with p = 10?6) than in "CHW" areas (from 24? to 11?, with p = 0.01). The results suggest that mothers with the appropriate training, equipment and supervision are able to manage cases of ARI.

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