The Fragility of Legitimacy: Access to Health Care in Manantali, Mali

Koenig, Dolores; Diarra, Tiéman

doi:10.1007/978-3-031-25592-2_4

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Mali, but several obstacles made it hard for people to receive good quality care: (i) it is a fee-forservice system and although fees are kept low, people had difficulty to afford the treatments; (ii) the transport to a CSCOM and more specialised secondary health facilities (often further away) was challenging because of the distance and the cost; and (iii) the CSCOM is dependent on the income it gains from the fees, and experienced difficulties to cover expenses. As a result, quality of care remained low, with less emphasis on prevention (Koenig & Diarra, 2023). Overall health of farm animals is challenged by seasonal feed shortages and a high disease burden, while the current vaccination strategies and veterinary services are poorly established throughout the country.…”

Section: On Farm: Suitable Si Options Matching Farmers' Coping Strate...mentioning

confidence: 99%

Not wrapped up in cotton wool : how risk influences farming in southern Mali

Huet

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West African farmers are exposed to a variety of risks, including climate variability. Moreover, trends of population growth, declining natural resources and climate change increase the probability of hazards and extreme events. In this environments, farmers are often struggling to be food selfsufficient or escape poverty. We focused on the area of Koutiala, southern Mali, as an illustrative region for the challenging farming conditions in West Africa.The aim of this thesis was to understand farmers' strategies to cope within a variable and hazardous environment. A parallel objective was to analyse which sustainable intensification options could increase productivity and/or reduce risks within the socio-economic and biophysical context. Risk was defined as the combination of the probability of a hazard taking place and the impact this induces. To analyse risk perception and suitability of on-farm options several data sources were combined: responses from individual surveys and focus group discussions, outputs from crop model simulations, long-term weather data and evaluations of trials and try-out fields embedded within a long-term participatory process.Risks related to health of family members were perceived as the highest, followed by risks related to health of livestock. Farmers managed those risks by maintaining flexibility and diversity in the farm management which allowed them to limit the impact and react quickly when hazards happened.Farmers overcame losses by relying on social interactions and using productive assets, e.g. selling cattle. Hence, they lost capital. Within households, differences in risk perception were related to decision-power, not to gender. Between farms, risk perception was related to resource endowment to a limited extent. The frequency and impact on yield of some hazards were quantified using crop simulation data. Weather hazards occurred at least every five years and reduced cereal yields. The impact of hazards on cereal yields (maize, sorghum, millet) interacted with the cereal management (early sowing, increasing N fertilisation and/or introducing a short duration variety). Increasing maize yields through management did not affect relative yield losses in case of hazards. Adapted millet management caused a trade-off between yield and hazard impact. Adapted sorghum management increased yield and mitigated hazard impacts simultaneously. Further, I demonstrated that on-farm diversification of crop land allocation had the potential to increase stability. The combination of cotton and a cereal had a relatively strong stabilisation benefit, as cotton and the cereals responded differently to weather. While the majority of diversification strategies enabled farmers to meet the food sufficiency requirements, farmers had to target combinations with a high mean return and large variability in order to surpass the poverty line. Within this environment, an iterative and participatory co-learning cycle facilitated a learning environment for researchers and farmers. This process yielded a diver...

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Section: On Farm: Suitable Si Options Matching Farmers' Coping Strate...mentioning

confidence: 99%

Not wrapped up in cotton wool : how risk influences farming in southern Mali

Huet

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Save life! Optimization of dynamics for pharmaceutical distribution performance

Mwakyeja,

Kimario

2024

MANM

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PurposeOptimization of dynamics determining distribution performance of pharmaceuticals is vital in realizing Sustainable Development Goal (SDG) number 3 which insists on provision of good health and well-being to the society. This study was designed at unfolding diverse factors that influence the distribution performance of pharmaceuticals in the Medical Stores Department (MSD) of Tanzania.Design/methodology/approachThis study utilized cross-sectional survey strategy in gathering data from 67 staff members working in the MSD using census approach. A structured questionnaire facilitated the collection of quantitative data which were later analyzed using ordinal logistic regression.FindingsThe results disclosed that all variables of inventory management, information management system and facility location positively and significantly govern the distribution performance and henceforth rejection of the foreseen null hypothesis.Research limitations/implicationsThis study realized dynamics inducing distribution performance of pharmaceuticals but did not cover the role of 3PLS and 4PLS in enhancing the same, and hence, an imminent study ought to seal this gap. Also, having grasped management information system is of strategic pillar, then it would sound imperative to analyze the application of artificial intelligence in distribution system performance.Originality/valueThis paper assimilates the concept of subaspects of supply chain management in footings of distribution management and that of pharmaceuticals and hence multidisciplinary value addition. Also, this study illustrates the applicability of strategic choice theory in strategic management in developing countries through pertinent choice of inventory management, information management system and facility location in triumphing SDGs.

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The Fragility of Legitimacy: Access to Health Care in Manantali, Mali

Cited by 2 publications

References 9 publications

Not wrapped up in cotton wool : how risk influences farming in southern Mali

Not wrapped up in cotton wool : how risk influences farming in southern Mali

Save life! Optimization of dynamics for pharmaceutical distribution performance

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