The Agence Nationale d’Evaluation et d’Accréditation des Etablissements de Santé, abbreviated to ANAES, is responsible for the evaluation and accreditation of healthcare establishments:
– external evaluation of healthcare establishments in terms of quality of care, cost control and impact on public health and medico-economics;
– to evaluate health care facilities with a view to classifying them as benchmarks in the health care system;
– promote the development of care and professional practice assessment within healthcare establishments.

According to the provisions of article 3 of Decree no. 2022-0112/PT-RM of February 24, 2022, setting out the organization and operating procedures of the Agence Nationale d’Evaluation et d’Accréditation des Etablissements de Santé (ANAES), an evaluation is defined as: «an act enabling a judgment to be made, according to a critical approach using systematic data collection, about multiple objects with a view to making decisions».

Evaluation usually aims to determine the relevance, efficiency, effectiveness, impact and sustainability of a process or procedure. In other words, it aims to systematically and objectively assess the relevance, performance and success (or lack thereof) of ongoing or completed programs and projects.

Evaluation is undertaken selectively to answer specific questions that will guide decision-makers or state authorities.

In February 2022, the Transitional Government, under the impetus of the Ministry of Health and Social Development, adopted the texts setting up, organizing and operating ANAES in place of the Agence Nationale d’Evaluation des Hôpitaux, abbreviated to ANEH.

Henceforth, evaluation will no longer focus solely on public hospitals and private establishments participating in the public hospital service, but on all healthcare establishments (public and private), in accordance with the French Health Orientation Act.

Between 2005 and 2021, ANEH, now replaced by ANAES, carried out over 200 assessment activities, including
– assessment of the quality of care ;
– annual assessment of hospital performance;
– evaluation of the implementation of facility projects;
– evaluation of hospital waste management;
– evaluation of hospital reform implementation;
– assessment of human resources management.

To assess a healthcare facility, ANAES :
– draws up terms of reference ;
– draws up a protocol setting out the indicators for each type of assessment, the assessment criteria or grids, the rate set and the method of calculation for each of the indicators selected;
– on the one hand, presents the protocol and collects the data, and on the other hand, returns the provisional results of the data collection to the health care facility concerned;
– notifies the health care facility concerned of the provisional report, for any relevant and/or justified comments;
– drafts and validates the final report, which is forwarded to the health care facility concerned, on the one hand, and to the Ministry of Health, on the other.

The final report on the assessment of a health care facility reveals the results of the data collection in terms of strengths and weaknesses, analyzes the said results and formulates recommendations whose diligent and correct implementation will enable the health care facility to strengthen or maintain the quality of health care and services offered to patients or users, on the one hand, and to improve its governance, on the other.

ANAES, formerly ANEH, carries out regular assessments, notably of the performance of 2nd and 3rd referral public hospitals and private hospitals participating in the public hospital service, on the one hand, and of the quality of care provided by public hospitals, including the Centres de Santé de Référence (CSREF), which have been transformed into district hospitals since 2018, on the other.

With regard to performance assessment, the evaluation criteria are based on general indicators for all 2nd and 3rd referral hospitals and private hospitals participating in the public hospital service, on the one hand, and those specific to each hospital, on the other.

The various indicators are chosen by mutual agreement between the Ministry of Health, ANAES and the public hospitals and private hospitals participating in the public hospital service.

These indicators are generally cyclical, with a review scheduled every three (03) years.

As a reminder, the performance evaluation of 2nd and 3rd referral public hospitals (Kayes, Sikasso, Ségou, Mopti, Tombouctou, Gao, CHU Pr Bocar Sidy SALL de Kati, hôpital du Mali, CHU Gabriel TOURE, CHU du Point-G, , CHU Odonto-Stomatologie Pr Hamady TRAORE, Hôpital Dermatologique de Bamako, CHU IOTA and Hôpital Mère et Enfant de Luxembourg de Bamako), for the year 2021, focused on 17 indicators, 13 of which were general to all the aforementioned hospitals and 4 specific to each hospital.

The general indicators related to
– the average number of out-of-stock days for 40 Essential Generic Medicines and consumables;
– the average number of days of immobilization of 10 key items of equipment;
– revenue collection rate;
– user satisfaction rate;
– hospital waste management compliance rate;
– the compliance rate for emergency care;
– average availability rate of 10 biomedical examinations;
– the rate of files retrievable from the admissions office by unique number;
– medical records compliance rate;
– the average functionality rate of administrative and management bodies (Board of Directors, Executive Committee, Medical Committee, Nursing and Maternity Care Commission, Health and Safety Technical Committee and Technical Committee);
– the rate of monthly clinical staff meetings per year at hospital level;
– the proportion of research protocols implemented per year;
– the hospital’s self-financing capacity.

Specific indicators for each of the 14 hospitals included:
– radiotherapy completion rate ;
– in-hospital neonatal mortality rate;
– in-hospital mortality rate for children aged 1-59 months;
– in-hospital mortality rate
– in-hospital maternal mortality rate;
– in-hospital mortality rate;
– percentage of patients receiving 2 x 4-hour dialysis sessions per week;
– percentage of patients receiving cancer chemotherapy;
– rate of management of open musculoskeletal fractures within 24 hours of hospital arrival;
– the success rate of hip prostheses;
– in-hospital maternal mortality rate;
– in-hospital mortality rate;
– the percentage of retinal detachments managed and restored to at least 1/10 visual acuity;
– the average rate of complete remission of non-metastatic retinoblastoma cases managed;
– the rate of patients no longer tearing after Dacryocystorhinostomy (DCR) at 30 days;
– the rate of patients with good palpebral correction at 30 days;

At the end of the performance evaluation of 2nd and 3rd referral public hospitals and private hospitals participating in the public hospital service, for the year 2021, a workshop was organized, under the responsibility of the Ministry of Health and Social Development, to develop and adopt the new cycle of indicators.

The number of indicators has been increased from 17 to 23, of which 17 are general and 06 specific.