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Table 1 Impact of conflict on the health system in the north and south of Mali [18]

From: Diabetes in an emergency context: the Malian case study

WHO Health System Building Block

North of Mali

South of Mali

Service delivery

• Limited services provided by NGOs

• Extra burden on existing services due to the number of internally displaced population

• Only 7.9% of health facilities were providing diabetes services

• Limited availability of free health services

• Services provided by UN agencies or NGOs versus Malian health service

• 65% of health facilities were not functional

Healthcare workforce

• Flight from conflict zone

• Insufficient health workers to accommodate the massive internal displacement (more than 300,000 internally displaced persons mainly to the region of Mopti)

• Limited number of NGOs and local resident health workers providing limited services

Information

• Lack of accurate and credible health information

• Lack of capacity to collect regular data in addition to supplementary data to manage crisis

• Malaria and measles epidemics detected by NGOs

Medical products, vaccines and technologies

• Complete interruption of supplies

• Lack of supplies at facilities for the people with diabetes already being managed

• Destruction of existing infrastructure

• Additional burden further strained existing limited resources

Financing

• Role of United Nations and NGOs versus government

• Health services partly financed by government and bilateral and multilateral donors, UN agencies and NGOs

• The population in the south received no additional support and due to the influx of people from the north and crisis situation actually received less support than prior to the crisis

• Limited partners support (44% of the health financing in Timbuktu Region)

Leadership and governance

• Absence of local Malian government authority in north of country

• Instability of the transitional government

• Lack of leadership for policy issues