The Director General of the National Agency for the Evaluation and Accreditation of Healthcare Facilities (ANAES) discusses the benefits of hospital evaluation, the criteria considered, and the shortcomings observed in these healthcare facilities.
L’Essor: ANAES has announced the results of the 4th edition of hospital evaluation for the year 2021. What analysis do you make of it?
Sékouli Fadjadji Touré: I would like to emphasize that the evaluation of hospital performance is a necessity because it truly allows us to assess the level of indicators. It also gauges the degree of involvement of users in the continuous improvement of the quality of care. Our evaluation is based on the year N minus 1 for greater credibility and efficiency. There is a cycle related to the evaluation called the triennial cycle.
The indicators are developed over three years. We conduct this evaluation N minus 1 because there are indicators whose results need to be looked at throughout the year. The result of this evaluation has identified the real problems encountered by the evaluated hospital establishments, measured user satisfaction, and made corrections to improve the quality of services to the great satisfaction of the population.
L’Essor: What are the criteria for evaluating hospitals?
Sékouli Fadjadji Touré: These are objective criteria that have been validated by mutual agreement not only with hospitals but also with the Ministry of Health and Social Development. We first organize a workshop on all indicators. It is a participatory process during which hospital managers are involved at all levels. That’s why the results are not disputable. They sincerely reflect the data from the hospitals.
In addition, the evaluators are practitioners, including doctors, administrators, specialists in hospital management, and health economics. We had 17 indicators for the recently concluded cycle, including 13 general indicators that apply to second and third reference hospitals with a general and specialized vocation. The indicators focused on the satisfaction rate of users, compliance with the management of hospital waste, and the emergency care system.
Also, the average availability rate of 10 biomedical tests, retrievable files from the entry desk by a unique number, the compliance rate of medical records, and the average functionality rate of administrative and management organs. There are also 4 specific indicators.
Thirteen public hospitals and the Mother and Child Hospital or Le Luxembourg underwent this evaluation. We will see how to integrate private hospitals such as the Mother and Child Hospital in Kayes gradually. We will conduct evaluations based on 23 indicators in the coming years.
L’Essor: Are the recommendations from the hospital performance evaluation being implemented?
Sékouli Fadjadji Touré: Certainly, these recommendations are being implemented. During evaluations, shortcomings are identified, and recommendations are made. The evaluation of hospital performance for the year 2021 allowed us to take stock of the implementation of hospital performance systems. It also noted the establishment and functionality of the hospital monitoring and animation committee in the 14 establishments, as evidenced by the completion of self-evaluation.
This committee is responsible for implementing recommendations under the supervision of the Ministry of Health and Social Development’s office. Despite all the shortcomings, since we started this process, the evaluated hospitals have shown significant progress.
Initially, many evaluation data that were very low have improved significantly. The level of indicators is progressing in several hospital establishments compared to 2020. However, neonatal and infant deaths remain a concern in almost all evaluated hospitals.
L’Essor: Are you convinced of the commitment of other hospitals, given that the University Hospital Center (CHU) of Kati Bocar Sidy Sall and the hospital in Sikasso continue to top the list?
Sékouli Fadjadji Touré: Of course! There is a commitment from other structures because the evaluation itself is an obligation. It is an essential component of public policy. Everyone would like to be honored. Beyond that, it is an emulation. The evidence is that the National Odonto-Stomatology Center Pr Hamady Traoré has disrupted the Hospital of Mali to take the third place.
These results show that the three award-winning structures make a lot of efforts. Others are on the same path, but they still have shortcomings to address. There is a strong enthusiasm for this evaluation today. Hospitals understand the need to constantly strive for quality care. We therefore congratulate the management of CHU Pr Bocar Sidy Sall, which has been able to retain its leading position. It is very significant.
L’Essor: What shortcomings were observed during the evaluations of the 4th edition?
Sékouli Fadjadji Touré: These are related to the emergency care system, the management of hospital waste, and the high rate of neonatal and intra-hospital infant mortality in our structures that record a large number of deliveries. If we respect the health pyramid, parturients should not end up at these hospitals. The Ministry of Health is taking steps to ensure that the evacuation-reference system is respected by users.
L’Essor: What message do you have to convey?
Sékouli Fadjadji Touré: Our goal is to ensure that all hospital structures, including private ones, reach a score of 100%. This year, ANAES will evaluate the performance contracts signed between hospital directors and the supervisory authority. I invite the population to not only trust our hospital structures but also make suggestions to contribute to the promotion of our hospital establishments.
Today, efforts are made by all personnel in these care structures for more quality despite the difficulties. These are inherent in any
This evaluation represents an opportunity to further strengthen the performance contract system signed between the Minister of Health and hospital directors. It also encourages the commitment of all stakeholders to quality healthcare.
Once again, the University Hospital Center (CHU) Pr Bocar Sidy Sall in Kati has been crowned the first winner of the hospital performance evaluation for the year 2021, as in the previous edition. It occupies the top of the ranking with a score of 103 out of 135.
This distinction was awarded yesterday during the 4th edition of the hospital performance evaluation. Organized by the National Agency for the Evaluation and Accreditation of Healthcare Facilities (ANAES), the results restitution ceremony was chaired by the representative of the Minister of Health and Social Development, Souleymane Traoré. It was attended by the Director General of ANAES, Sékouli Fadjadji Touré, and hospital directors.
The CHU in Kati received a symbolic reward, namely a check for 750,000 Fcfa. The hospital in Sikasso, which was ranked second with a score of 97 points, received 500,000 Fcfa. The National Odonto-Stomatology Center Pr Hamady Traoré ranked third with 95 points on the same denominator. This establishment also received a symbolic check for 250,000 Fcfa.
This hospital evaluation aims to distinguish and reward the most performing establishments to create healthy competition among them in order to increase their performance. For the year 2021, ANAES evaluated 14 hospitals through thirteen general indicators and four specific indicators, the relevance and calculation method of which were agreed upon with stakeholders.
Among the indicators are the average number of days of stockouts of 40 Essential Generic Medicines (EGM) and tracer consumables, the average number of days of immobilization of 10 key equipment, the revenue recovery rate, and the user satisfaction rate. Additionally, the average availability rate of 10 biomedical tests, self-financing capacity, intra-hospital mortality rate, and the proportion of implemented research protocols.
In general, as explained by the Director General of ANAES, aspects related to drug and reagent stockouts, equipment breakdown, hospital waste management, governance, and user satisfaction have seen a clear improvement in hospitals. Sékouli Fadjadji Touré assured that hospital establishments have demonstrated their adaptability through the establishment of animation committees and the development of a culture of self-assessment.
For him, the implementation of recommendations made during various evaluation missions has undoubtedly raised the level of quality of care within these establishments. The head of ANAES also estimated that these results are the result of teamwork and the commitment of the agency’s staff.
The representative of the Minister of Health and Social Development recalled the context of the ceremony, placed under the sign of continuous improvement of professional practices oriented towards humane care. According to him, these evaluations constitute an opportunity to further strengthen the performance contract system signed between his department and hospital directors, but also to encourage the commitment of all stakeholders to quality care.
“For us, it is about strengthening the achievements we have and ensuring that the best examples and recommendations made during successive evaluation missions are capitalized,” noted Souleymane Traoré. And to say that these contracts will be evaluated this year.
The three winners have promised to redouble their efforts to provide quality care to the population. It is now up to other hospitals to follow in the footsteps of these top-performing institutions.
Makan SISSOKO
For the Journal “L’Essor”
The National Agency for the Evaluation and Accreditation of Healthcare Facilities (ANAES) held a workshop last Wednesday at a hotel in Kita to inform and sensitize key stakeholders in community health in the Kita Region. The event was chaired by the Prefect of Kita, Abrham Kassogué, and attended by many other guests.
The meeting aims to obtain the full commitment of these stakeholders to the healthcare facility accreditation process. This activity allowed sharing key information with stakeholders and preparing the ground for ANAES accreditation teams.
Undoubtedly, an accredited healthcare facility reassures users that the care it provides meets the required quality standards. It also assures the state and other healthcare system stakeholders that it has the capacity to perform certain activities.
Accreditation is one of the main pillars of results-based management. This is why, for some time now, ANAES has been working to evaluate and accredit healthcare facilities.
This is done to enhance the technical capabilities and guide healthcare facilities toward inclusive and equitable quality care for the benefit of the population. In anticipation of healthcare facility accreditation activities, the Agency deemed it necessary to engage with various stakeholders in the healthcare system in the Kita Region on the process.
According to the representative of the Director-General of ANAES, Dr. Adama Koné, from 1998 to the present day, the number of Community Health Centers (cscom) has reached 1,470. This extensive network of healthcare facilities has ensured good health coverage in a short radius and has achieved better results in terms of key health indicators, but also in strengthening. For him, accreditation now seems to be the ultimate solution. He notes that his structure relies on tools from a reference framework designed and successfully tested by experts in the field and partners including Gavi (the Vaccine Alliance). Governance, personnel and qualification, suitable environment, protocols and procedures, quality, and safety are among the elements of this framework, he emphasizes.
For Abrham Kassogué, accreditation is an essential tool to improve the performance of the healthcare system, hence the important role of this workshop, especially to encourage decision-makers to adopt appropriate options to develop a culture of evaluation and, above all, accreditation within healthcare facilities.
“Thus, as part of the Strengthening of the Health System (RSS), the government has pursued a health policy with the main strategic foundation being the monitoring, evaluation, and strengthening of the health system to enable various health action programs to achieve their objectives.
To achieve this, there is a need for the involvement of the quality approach within healthcare facilities, the culmination of which is accreditation,” said the prefect. He invited stakeholders to engage in the accreditation process, which is a political will expressed by the authorities and advocated in the Ten-Year Health and Social Development Plan (2014-2023). Also in various Health and Social Development Programs (Prodess), which are five-year phases of this plan. He urged everyone to do everything possible to help stakeholders better understand the importance of accreditation.
Jigiya Mohamed Fabrice
Amap-Kita
Reporting for the “L’Essor” newspaper
This new Agency is equipped with a system to encourage healthcare facilities to engage in continuous improvement of the quality of care. Its director general, Sékouli Fadjadji Touré, explains the challenges to overcome for the success of this noble mission.
L’Essor: ANAES was created on the ashes of the National Hospital Evaluation Agency (Aneh) with new responsibilities. Why this expansion of missions?
Sékouli Fadjadji Touré: Under the impetus of the Minister of Health and Social Development, Mrs. Diéminatou Sangaré, ANAES was created in February 2022 in response to several aspects, including the expansion of the healthcare system through the creation of clinics, cabinets, community health centers (Cscom), and Reference Health Centers (Csref) that are being transformed (for some) into district hospitals since 2018.
This evolution requires providing quality care to the population. It is pointless to treat patients in conditions where there is no quality. The second aspect is that the facilities must be accredited.
This aims to identify those that meet quality standards. We can no longer content ourselves with providing care that is not of quality. Based on these observations, the need to review the missions of Aneh was shared by the head of the Health department, who has always advocated for quality in healthcare.
It was necessary to broaden the evaluation missions to all healthcare facilities, both public and private. ANAES is responsible for conducting external evaluations of healthcare facilities regarding the quality of care, cost control, and the impact in terms of public and medico-economic health, to evaluate healthcare facilities for their classification in the reference level in the healthcare system.
It is also about promoting the development of the evaluation of care and professional practices. ANAES also has a mission to establish and implement accreditation procedures for healthcare facilities, as well as to propose to the minister responsible for health their accreditation and propose the subscription and withdrawal of subscription to public insurance organizations.
L’Essor: What will be the contributions of the Agency to our healthcare system, in terms of access to quality care?
Sékouli Fadjadji Touré: The ANAES system is very good. The State has given itself the means, through this service, to guarantee the quality of care. When a facility is accredited, the quality gradually improves, and it offers ideal conditions for patient care. The evaluation of healthcare facilities will therefore bring healthy competition in improving care for patients. This is done through the evaluation of achievements and shortcomings, as well as recommendations to the Minister of Health and Social Development for quality improvement.
L’Essor: ANAES has the mission of accrediting healthcare facilities. Is this the beginning of a fight against the proliferation of private healthcare structures that do not meet the requirements?
Sékouli Fadjadji Touré: Mali did not have a dedicated accreditation service. There are enforcement services, including health inspection. As soon as the process starts, it is the population that will sanction by refusing to go to these non-accredited structures. This accreditation process is participatory. The vision of the Health and Social Development department is to encourage managers of private or public structures to adopt the quality approach through tools and standards.
Each service level will have its standards that will be developed and validated by the authorities. The population will have the necessary information regarding the accreditation of healthcare facilities. Other structures will be involved in the accreditation process, such as the Directorate General of Health, the National Health Insurance Fund (Canam), and the National Institute of Public Health (INSP). The Minister in charge of Health has the discretion to accredit or not the evaluated structures. This accreditation can be withdrawn once the structure no longer meets the standards.
L’Essor: Which healthcare facilities will join the list of traditionally evaluated hospitals? How do you plan to meet this challenge?
Sékouli Fadjadji Touré: Aneh was focused on hospitals. This time, evaluations concern all public and private healthcare facilities. The health orientation law gives a patient the free choice to seek treatment wherever they want. That is the reason that implies this change so that all healthcare facilities offer quality to patients.
L’Essor: What are your expectations for the success of these new missions assigned to your Agency?
Sékouli Fadjadji Touré: We need technical support in terms of capacity building. We have highly experienced professionals in the field of evaluation. But accreditation is a new area. We are in the process of developing the tools needed for accreditation. Today, we have the tools needed for Cscom (Community Health Centers).
We will start accrediting at least 45 Cscom for the year 2023. We will develop other tools by reference level, namely for district hospitals, second, third, or even fourth reference, especially private ones.
Securing funding is one of the recommendations of the first session of our board of directors, held on January 26th. The state and technical and financial partners must provide the necessary support to ANAES to meet the challenge related to human, material, financial, and logistical resources.
So that it truly plays its part effectively and efficiently. So far, we have always benefited from the support of the State, but also from the professional health orders. We want everyone to play their role because we are all potential patients.
Interview by
Mohamed DIAWARA
Reporting for the “L’Essor” newspaper
The National Agency for the Evaluation and Accreditation of Health Facilities (Anaes) organized a workshop last Monday in Koulikoro to inform and sensitize key stakeholders about the accreditation process for Community Health Centers (Cscom).
The opening of the workshop was presided over by the prefect of the Koulikoro Circle, Mrs. Coulibaly Mariam Coulibaly, in the presence of the director-general of Anaes, Sekouli Fadjadji Touré, representatives of technical and financial partners, and other guests.
The meeting aimed to inform and guide key stakeholders on the accreditation process for Cscom. “We are pleased with the choice of the Koulikoro Region for this quality approach, which undoubtedly allows, on the one hand, the improvement of the performance indicators of health centers and, on the other hand, access to quality care for the population,” introduced the prefect of Koulikoro. She also clearly stated that this workshop is part of a dynamic of overall evaluation of the quality of care and processes. Mrs. Coulibaly Mariam Coulibaly also specified that the meeting represents a framework for discussions to guide stakeholders in their mission to guarantee quality care to the population.
For his part, the director-general of Anaes outlined the context of the workshop. “The government has pursued a health policy with the main strategic foundation of monitoring, evaluating, and strengthening the health system to enable various health programs to achieve their objectives.”
According to Sekouli Fadjadji Touré, the accreditation of health facilities is a political will displayed by the authorities. Thus, accreditation has been recommended in the Decennial Plan for Health and Social Development (PDSS) 2014-2023 and in the various Decennial Plans for Health and Social Development (Prodess), which represent five-year phases of this plan.
The presentation by Dr. Keïta Fatoumata Bagayoko on Anaes, the context, and the development of the accreditation tool for Cscom, as well as the role and responsibility of actors during accreditation visits, sparked reactions and fruitful exchanges on the entire evaluation and accreditation process.
Many questions from participants focused on the difference between accreditation by Results-Based Financing (RBF) and that of Anaes, the steps to follow to request advisory support and the associated costs.
Questions like why other Cscom not covered by RBF were not involved, who is involved in the accreditation of Cscom, who covers the expenses related to the accreditation team’s (Anaes) travel, and what type of expenses the Community Health Association (Asaco) must bear in the accreditation process were also addressed.
Calm responses were provided by the director-general of Anaes and his team. This information and awareness workshop, according to the initiators, was a real success. The objective was achieved. Considering the interest shown by everyone on the issue, the Koulikoro Region has committed to the quality of care at the Cscom level, Dr. Keïta Fatoumata Bagayoko stated succinctly.
It is useful to note that the Koulikoro Circle has 23 Cscom. Two of them have been accredited, and 15 others are on the list for upcoming accreditations.
Amadou MAÏGA
Amap-Koulikoro
For the “L’Essor” newspaper
The National Agency for the Evaluation and Accreditation of Health Facilities (Anaes) and Palladium Group International signed a memorandum of understanding yesterday at the agency’s premises as part of the implementation of the Keneya sinsi walé Project related to strengthening the health system in Mali. The project is financed by the United States Agency for International Development (USAID).
The signing ceremony was presided over by the representative of the Minister of Health and Social Development, Hamadoun Dicko, in the presence of the Director-General of Anaes, Sékouli Fadjadji Touré, and the Director of the Keneya sinsi walé Project, Roland Koné.
This memorandum of understanding includes strengthening Anaes’ partnership network in the accreditation field, support for the orientation and information workshop for actors in the accreditation of Community Health Centers (Cscom) in the Sikasso, Ségou, and Mopti Regions.
This agreement will also support the conduct of accreditation visits to medical biology laboratories and Cscom in the regions concerned. Additionally, it includes technical support for the functionality of coordination platforms at the central level with Anaes, technical and financial support for the institutional capacity building of Anaes to carry out accreditation missions.
The Director-General of Anaes explained that this signing ceremony reflects the Ministry of Health and Social Development’s commitment to support the process of continuous improvement of professional practices within our health facilities.
“We hope that the signing of the partnership agreement will bring new impetus to the bilateral collaboration between Anaes and its partners who share common values,” said Sékouli Fadjadji Touré. He also expressed the hope that the clauses of this agreement will be implemented without delay so that the population can enjoy increased access to quality healthcare.
The Director of the Keneya sinsi walé Project stated that the project is funded by
USAID to the tune of $45 million, approximately XOF 27.5 billion over five years. Implemented by Palladium Group International, it aims to strengthen the health system in the regions of Ségou, Sikasso, and Mopti. Roland Koné also mentioned
that this project is committed to working closely with Anaes to conduct the accreditation process for 135 Cscom, representing 20% of all Cscom in the three
concerned regions. In 2023, he indicated, the short-term goal is to accredit 45 Cscom by September of this year.
The head of the Keneya sinsi walé Project also recalled that his team participated in the development and validation of health facility accreditation tools with several partners. He expressed his gratitude to USAID and the Health Department for their contributions to the project’s implementation.
The representative of the USAID Health Office in Mali stated that this intervention by the organization adds to other contributions from the US government to strengthen health, the availability, and use of a package of quality services for women and children. “We have noted with satisfaction an expansion of Anaes’ competence,” said Sidi Yéya Cissé.
Hamadoun Dicko estimated that through this memorandum of understanding, the two organizations will be able to share their experiences to develop skills and exchange accreditation-related matters. Finally, he emphasized that accreditation remains a strategic choice of the authorities to boost the health system through the establishment of quality management tools.
Mohamed DIAWARA
Source of the article: https://lessor.ml/posts/accreditation-des-centres-de-sante-le-projet-keneya-sinsi-wale-pret-a-accompagner-lanaes-64817b53942a2